AMY PETTENGILL (NPI# 1457916660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457916660 |
| Entity Type | Individual |
| Full Name | AMY PETTENGILL |
| Credential | LADC |
| Practice Address |
293 Wilson St Manchester NH 03103-5021 |
| Mailing Address |
122 Market St Manchester NH 03101-1952 |
| Practice Telephone | 6036419441 |
| Practice Fax Number | 6038366999 |
| Mailing Telephone | 6036419441 |
| Mailing Fax Number | 6038366999 |
| Enumeration Date | 2019-05-02 |
| Last Update Date | 2019-05-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
0957 | NH | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 15 Brook St, Manchester, NH 031043508 | 6036419441 |
| Street Address |
293 WILSON ST |
| City | MANCHESTER |
| State | NH |
| Zip Code | 03103-5021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194057455 | Tara Rousselle | Counselor | 293 Wilson St, Manchester, NH 03103-5021 | 2010-02-10 |
| 1972120996 | Jessica Lee Vintinner | Specialist | 293 Wilson St, Manchester, NH 03103-5008 | 2020-06-26 |
| 1114558764 | Kimberly Johnson | Counselor | 293 Wilson St, Manchester, NH 03103-5008 | 2020-02-03 |
| 1700349024 | Janelle Brophy | Peer Specialist | 293 Wilson St, Manchester, NH 03103-5021 | 2019-04-12 |
| 1588136584 | Marilyn Selfridge | Counselor | 293 Wilson St, Manchester, NH 03103-5021 | 2019-01-02 |
| 1487125902 | Kimberly Marshall | Specialist | 293 Wilson St, Manchester, NH 03103-5021 | 2018-12-10 |
| 1548739519 | Hilary Hopkin | Social Worker | 293 Wilson St, Manchester, NH 03103-5021 | 2018-11-19 |
| 1194208041 | Jacklyn Ruth Jones | Counselor | 293 Wilson St, Manchester, NH 03103-5008 | 2018-09-06 |
| 1609356377 | Annie Day | Peer Specialist | 293 Wilson St, Manchester, NH 03103-5021 | 2018-08-21 |
| 1770063489 | Heather Williams | Peer Specialist | 293 Wilson St, Manchester, NH 03103-5021 | 2018-08-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023583374 | Melissa K Bascom | Social Worker | C/o Care Coordination Department, 1 Elliot Way, Manchester, NH 03103 | 2018-10-12 |
| 1538650650 | Bluestone Healthcare Services L.L.C. | Physician Assistant | Bluestone Healthcare Services LLC 169 South River Rd, Bedford, NH 03103 | 2018-05-24 |
| 1538662424 | Minal Jamkhande | Pharmacist | 50 S Willow Street, Manchester, NH 03103 | 2018-03-16 |
| 1447776240 | Manchester Health Supplies | Durable Medical Equipment & Medical Supplies | 373 S Willow Street, #328, Manchester, NH 03103 | 2017-08-14 |
| 1184145898 | Susan E Herman | Physical Therapist | 3000 Goffs Falls Road Suite 101, Manchester, NH 03103 | 2017-07-03 |
| 1316476757 | Sara Rose Hanrahan | Occupational Therapist | 3000 Goffs Falls Road, Suite 101, Manchester, NH 03103 | 2017-06-08 |
| 1457802811 | Holly Ann Cekala | Counselor | 140 Central St, Manchester, NH 03103 | 2016-10-20 |
| 1114301249 | Families In Transition | Counselor | 282 Belmont St, Manchester, NH 03103 | 2015-07-18 |
| 1083092282 | Alexander Michael Jones | Family Medicine | 4 Elliot Way Ste 105, Manchester, NH 03103 | 2015-05-08 |
| 1518344100 | Janiris Ruth Matos | Dentist | 8 Vinton Street, Dental Clinic, Manchester, NH 03103 | 2015-05-03 |
| Find all providers in zip 03103 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841891843 | Faithanne Blue | Counselor | 60 Rogers St Unit 1, Manchester, NH 03103-5070 | 2020-11-05 |
| 1073129367 | Deborah Lynn Bowles-lee | Counselor | 1541 Sainville Rd, Manchester, TN 37355-6248 | 2020-09-22 |
| 1477199081 | Helping Hands Outreach Ministries, Inc. | Counselor | 50 Lowell St, Manchester, NH 03101-1635 | 2019-11-19 |
| 1710538673 | Samantha Corinne Boutsianis | Counselor | 206 Jewett St Apt 2b, Manchester, NH 03103-2879 | 2019-09-23 |
| 1306493531 | Mackenzie Ryan Seely | Counselor | 293 Wilson Street, 3rd Floor, Manchester, NH 03103-5021 | 2019-08-22 |
| 1174178743 | Melissa Ann Kimball | Counselor | 60 Rogers St Unit 204, Manchester, NH 03103-5070 | 2019-08-09 |
| 1871145086 | Healthy Solutions | Counselor | 643 Main Street, Manchester, CT 06084 | 2019-07-09 |
| 1629639034 | Mano-en-mano Hand In Hand,llc | Counselor | 843 Main St Ste 10, Manchester, CT 06040-6041 | 2019-06-26 |
| 1619432994 | Michelle Lee Poulin | Counselor | 303 Belmont St, Manchester, NH 03103-4311 | 2019-01-31 |
| 1770056632 | Joan Catharine Sementa | Counselor | Sununu Youth Center, 1056 River Road, Manchester, NH 03104-0305 | 2019-01-03 |
| Find all providers in MANCHESTER | ||||
| City | MANCHESTER |
| Zip Code | 03103 |
Please comment or provide details below to improve the information on AMY PETTENGILL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.