Basic Information
| Provider Information | |||||||||
| NPI: | 1720143993 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TORP | ||||||||
| FirstName: | CARIN | ||||||||
| MiddleName: | |||||||||
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| Credential: | MA ADTR LCMHC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 531 MARLBORO ST | ||||||||
| Address2: | |||||||||
| City: | KEENE | ||||||||
| State: | NH | ||||||||
| PostalCode: | 034314312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6033571180 | ||||||||
| FaxNumber: | 6033571185 | ||||||||
| Practice Location | |||||||||
| Address1: | 222 WEST ST | ||||||||
| Address2: | SUITE 29E | ||||||||
| City: | KEENE | ||||||||
| State: | NH | ||||||||
| PostalCode: | 034312455 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6033571180 | ||||||||
| FaxNumber: | 6033571185 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/27/2006 | ||||||||
| LastUpdateDate: | 05/07/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 462 | NH | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
ID Information
| ID | Type | State | Issuer | Description | 30426653 | 05 | NH | MEDICAID |