ANGELIQUE ALICIA FORTIN (NPI# 1598121188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598121188 |
| Entity Type | Individual |
| Full Name | ANGELIQUE ALICIA FORTIN |
| Other Name | ANGIE LONG/ROBERTS |
| Practice Address |
77 Pearl St. Manchester NH 03101 |
| Mailing Address |
603 Main St Gorham NH 03581 |
| Practice Telephone | 6036219870 |
| Practice Fax Number | 6036219875 |
| Mailing Telephone | 6032156482 |
| Mailing Fax Number | 6032156658 |
| Enumeration Date | 2016-01-12 |
| Last Update Date | 2020-08-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
2035 | NH | Behavioral Health & Social Service Providers |
| Street Address |
77 PEARL ST. |
| City | MANCHESTER |
| State | NH |
| Zip Code | 03101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003320425 | Miranda Sherburne | Occupational Therapist | 470 Pine Street, Manchester, NH 03101 | 2017-11-21 |
| 1396266938 | Juliette W Daniels | Social Worker | 464 Chestnut Street, Child and Family Services, Manchester, NH 03101 | 2017-07-05 |
| 1851820450 | Samantha Ysabelle Kattiria | Specialist/Technologist | 39 Kosciuszko Street, Apt 4, Manchester, NH 03101 | 2017-06-07 |
| 1578946786 | Reta Goldman | Counselor | 25 Lowell St Ste 208, Manchester, NH 03101 | 2015-07-07 |
| 1306239207 | Myra Jean Nikitas | Dental Hygienist | 97 West Merrimack Street, Manchester, NH 03101 | 2015-03-17 |
| 1902234586 | Judith Patrick Ronshagen | Pharmacist | 175 Queen City Avenue, Ste 1, Manchester, NH 03101 | 2013-10-17 |
| 1942566336 | Elizabeth Zavagnin | Specialist | 2 Wall St Ste 200, Manchester, NH 03101 | 2012-04-10 |
| 1538463088 | William Gerald Mccormick | Pharmacist | 175 Queen City Ave, Manchester, NH 03101 | 2010-12-27 |
| 1215241799 | Melissa Ann Dinoto | Counselor | 20 Market St., Manchester, NH 03101 | 2010-07-27 |
| 1164750873 | Monarch Therapeutic Massage, LLC | Massage Therapist | 30 Amherst St, #1, Manchester, NH 03101 | 2009-11-19 |
| Find all providers in zip 03101 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841800497 | Meghan N Braley | Counselor | 13 Ancient County Way, Manchester, MA 01944-1247 | 2020-08-07 |
| 1154930600 | Lillian Sarah Pernoud | Counselor | 734 Chancellor Heights Dr, Manchester, MO 63011-3577 | 2020-07-29 |
| 1962026252 | Andrea Rose Mitchell | Counselor | 250 Commercial St Ste 2020, Manchester, NH 03101-1118 | 2020-06-02 |
| 1487115853 | Resilience & Hope LLC | Counselor | 66 Hanover St Ste 200, Manchester, NH 03101-2230 | 2019-03-28 |
| 1710441209 | Karen Ann Fontaine | Counselor | 87 Phelps Rd, Manchester, CT 06042-3209 | 2019-01-29 |
| 1043792427 | The Lodge Counseling | Counselor | 270 Knowlton St, Manchester, NH 03103-2870 | 2018-09-03 |
| 1114440930 | Alisha Nicole Stewart | Counselor | 565 Muddy Gap Rd, Manchester, KY 40962-7279 | 2017-07-24 |
| 1538689534 | Bernard Ashirifie | Counselor | 869 Main Street, Apt 3, Manchester, CT 06040 | 2017-06-21 |
| 1720527450 | Heather Ann Burgess | Counselor | 130 Old Essex Rd, Manchester, MA 01944-1208 | 2017-02-14 |
| 1689113318 | Elizabeth Diaz | Counselor | 510 Wellington Hill Rd, Manchester, NH 03104-6461 | 2017-02-14 |
| Find all providers in MANCHESTER | ||||
| City | MANCHESTER |
| Zip Code | 03101 |
Please comment or provide details below to improve the information on ANGELIQUE ALICIA FORTIN.
| 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.