Healthcare Provider Details

I. General information

NPI: 1689792673
Provider Name (Legal Business Name): THE PROFESSIONAL COUNSELING CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

466 COUNTY ST
NEW BEDFORD MA
02740-5107
US

IV. Provider business mailing address

466 COUNTY ST
NEW BEDFORD MA
02740-5107
US

V. Phone/Fax

Practice location:
  • Phone: 508-997-0794
  • Fax: 508-999-6607
Mailing address:
  • Phone: 508-997-0794
  • Fax: 508-999-6607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number4362
License Number StateMA

VIII. Authorized Official

Name: SANDRA DELGADO
Title or Position: ADMINSTRATOR
Credential: RN
Phone: 508-997-0794