Healthcare Provider Details

I. General information

NPI: 1174536809
Provider Name (Legal Business Name): ASSOCIATES OF MERRIMACK VALLEY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 CHELMSFORD ST
CHELMSFORD MA
01824
US

IV. Provider business mailing address

201 CHELMSFORD ST
CHELMSFORD MA
01824
US

V. Phone/Fax

Practice location:
  • Phone: 978-256-1467
  • Fax: 978-256-7465
Mailing address:
  • Phone: 978-256-1467
  • Fax: 978-256-7465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JOEL SIEGEL
Title or Position: PRESIDENT COOWNER CODIRECTOR
Credential: LICSW
Phone: 978-256-1467