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General NPI Number Information
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NPI Number | 1023529203
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Entity Type | Organization
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Legal Business Name | BEACON COUNSELING SERVICES
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Dates
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Enumeration Date | 10/16/2017
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Last Update Date | 10/16/2017
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Provider Practice Location Address
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Address Line | 140 ELLIOTT ST STE 5
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City | BEVERLY
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State | MA
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Zip | 01915-3220
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Country | US
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Telephone | 978-473-1346
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Fax |
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Provider Business Mailing Address
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Address Line | 11 BRUCE LN
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City | WENHAM
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State | MA
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Zip | 01984-1403
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Country | US
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Telephone | 978-473-1346
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Fax |
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Authorized Official
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Title or Position | MARRIAGE FAMILY THERAPIST
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Name | MS. MARIAN B VANCE
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Credential | LMFT
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Telephone | 978-473-1346
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1684
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License Number State | MA
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