Provider Demographics
NPI:1417833435
Name:UPPER VALLEY PSYCHIATRY P.L.L.C.
Entity type:Organization
Organization Name:UPPER VALLEY PSYCHIATRY P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CASSIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:KOSAREK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:802-526-4810
Mailing Address - Street 1:PO BOX 108
Mailing Address - Street 2:
Mailing Address - City:ENFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03748-0108
Mailing Address - Country:US
Mailing Address - Phone:802-526-4810
Mailing Address - Fax:603-448-0661
Practice Address - Street 1:3 LEBANON ST STE 39
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:NH
Practice Address - Zip Code:03755-2158
Practice Address - Country:US
Practice Address - Phone:802-526-4810
Practice Address - Fax:603-448-0661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service