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General NPI Number Information
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NPI Number | 1205915857
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Entity Type | Organization
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Legal Business Name | MARBLEHEAD COUNSELING CENTER INC
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 66 CLIFTON AVE
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City | MARBLEHEAD
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State | MA
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Zip | 01945
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Country | US
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Telephone | 781-631-8273
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Fax | 781-631-7264
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Provider Business Mailing Address
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Address Line | 66 CLIFTON AVE
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City | MARBLEHEAD
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State | MA
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Zip | 01945
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Country | US
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Telephone | 781-631-8273
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Fax | 781-631-7264
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. PAUL TIMOTHY CROSBY
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Credential | LICSW
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Telephone | 781-631-8273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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