Healthcare Provider Details

I. General information

NPI: 1871211219
Provider Name (Legal Business Name): BECOMINGYOU COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2022
Last Update Date: 08/22/2022
Certification Date: 08/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 STEPHEN AVE
DRACUT MA
01826-1333
US

IV. Provider business mailing address

24 STEPHEN AVE
DRACUT MA
01826-1333
US

V. Phone/Fax

Practice location:
  • Phone: 978-705-1498
  • Fax:
Mailing address:
  • Phone: 978-705-1498
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KRISTY BUCK
Title or Position: CLINICIAN
Credential: LICSW
Phone: 978-705-1498