Basic Information
Provider Information
NPI: 1407322530
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WEBSTER
FirstName: ABIGAIL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 2032
Address2:  
City: CONCORD
State: NH
PostalCode: 033022032
CountryCode: US
TelephoneNumber: 6032267505
FaxNumber:  
Practice Location
Address1: 53 KENDALL ST
Address2:  
City: FRANKLIN
State: NH
PostalCode: 032351413
CountryCode: US
TelephoneNumber: 6032267505
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/16/2018
LastUpdateDate: 09/30/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/30/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


Home