Healthcare Provider Details

I. General information

NPI: 1881747863
Provider Name (Legal Business Name): MERRIMACK VALLEY COUNSELING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2007
Last Update Date: 01/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

184 PLEASANT VALLEY ST
METHUEN MA
01844-5817
US

IV. Provider business mailing address

184 PLEASANT VALLEY ST
METHUEN MA
01844-5817
US

V. Phone/Fax

Practice location:
  • Phone: 978-687-4383
  • Fax: 978-685-4426
Mailing address:
  • Phone: 978-687-4383
  • Fax: 978-685-4426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3241
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number105170
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number426
License Number StateMA

VIII. Authorized Official

Name: MS. DEBORAH ANNE HUGHES
Title or Position: VICE PRESIDENT
Credential: M.SW.
Phone: 978-687-4383