Healthcare Provider Details

I. General information

NPI: 1952183956
Provider Name (Legal Business Name): COMMON THREADS COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2023
Last Update Date: 10/16/2023
Certification Date: 10/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70R WILDER RD
LEOMINSTER MA
01453-6643
US

IV. Provider business mailing address

PO BOX 484
WEST GROTON MA
01472-0484
US

V. Phone/Fax

Practice location:
  • Phone: 978-728-3661
  • Fax:
Mailing address:
  • Phone: 978-728-3661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: EMMA SCHRADER
Title or Position: OWNER
Credential: LMHC
Phone: 978-728-3661