Healthcare Provider Details

I. General information

NPI: 1467236521
Provider Name (Legal Business Name): ROSE MEADOW COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2023
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W MAIN ST BLDG B
NORTHBOROUGH MA
01532-2132
US

IV. Provider business mailing address

300 W MAIN ST BLDG B
NORTHBOROUGH MA
01532-2132
US

V. Phone/Fax

Practice location:
  • Phone: 508-925-0688
  • Fax:
Mailing address:
  • Phone: 508-925-0688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE FOUAD MOURAD
Title or Position: OWNER/CLINICIAN
Credential: LMHC
Phone: 508-925-0688