Healthcare Provider Details

I. General information

NPI: 1306765839
Provider Name (Legal Business Name): BEDROCK COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 GROSSMAN DR STE 205-4
BRAINTREE MA
02184-4962
US

IV. Provider business mailing address

150 GROSSMAN DR STE 205-4
BRAINTREE MA
02184-4962
US

V. Phone/Fax

Practice location:
  • Phone: 781-512-9707
  • Fax:
Mailing address:
  • Phone: 781-512-9707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: NATASHA SERRANO
Title or Position: CLINICAL MENTAL HEALTH COUNSELOR
Credential: LHMC, NCC
Phone: 781-512-9707