Provider Demographics
NPI:1871959809
Name:GAMACHE, JAMES (MSW, MLADC, ICAADC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:GAMACHE
Suffix:
Gender:M
Credentials:MSW, MLADC, ICAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1361 ELM ST
Mailing Address - Street 2:SUITE 207
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-1324
Mailing Address - Country:US
Mailing Address - Phone:603-634-4446
Mailing Address - Fax:603-634-4447
Practice Address - Street 1:1361 ELM ST
Practice Address - Street 2:SUITE 207
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-1324
Practice Address - Country:US
Practice Address - Phone:603-634-4446
Practice Address - Fax:603-634-4447
Is Sole Proprietor?:No
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0647101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)