Healthcare Provider Details

I. General information

NPI: 1487390605
Provider Name (Legal Business Name): NEW HEIGHTS COUNSELING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2022
Last Update Date: 05/10/2022
Certification Date: 05/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 CRAWFORD ST
NORTHBOROUGH MA
01532-1234
US

IV. Provider business mailing address

45 LYMAN ST
WESTBOROUGH MA
01581-2628
US

V. Phone/Fax

Practice location:
  • Phone: 508-330-2747
  • Fax:
Mailing address:
  • Phone: 508-330-2747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LINDSAY BRADY
Title or Position: OWNER
Credential: LICSW
Phone: 508-330-2747