Healthcare Provider Details

I. General information

NPI: 1891167318
Provider Name (Legal Business Name): CIRCLES OF CARE INC.46-3391910
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2015
Last Update Date: 10/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 WASHINGTON ST STE 202
SALEM MA
01970-3516
US

IV. Provider business mailing address

60 WASHINGTON ST STE 202
SALEM MA
01970-3516
US

V. Phone/Fax

Practice location:
  • Phone: 781-990-3290
  • Fax:
Mailing address:
  • Phone: 781-990-3290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9330
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number9330
License Number StateMA

VIII. Authorized Official

Name: MS. VICKY JEAN LOCKE
Title or Position: PRESIDENT
Credential: LMHC
Phone: 781-990-3290