Healthcare Provider Details

I. General information

NPI: 1104739085
Provider Name (Legal Business Name): HAZELWOOD COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 DEBRA DR
TEWKSBURY MA
01876-2708
US

IV. Provider business mailing address

81 DEBRA DR
TEWKSBURY MA
01876-2708
US

V. Phone/Fax

Practice location:
  • Phone: 978-994-6870
  • Fax:
Mailing address:
  • Phone: 978-994-6870
  • 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: ERIN CRAIL
Title or Position: OWNER
Credential: LCMHC
Phone: 978-994-6870