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General NPI Number Information
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NPI Number | 1265067482
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Entity Type | Organization
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Legal Business Name | THE HEALING TREE, LLC
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Dates
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Enumeration Date | 03/09/2020
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Last Update Date | 03/26/2021
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Provider Practice Location Address
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Address Line | 144 MERRIMACK ST STE 305
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City | LOWELL
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State | MA
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Zip | 01852-1710
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Country | US
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Telephone | 978-935-8032
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Fax |
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Provider Business Mailing Address
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Address Line | 144 MERRIMACK ST STE 305
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City | LOWELL
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State | MA
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Zip | 01852-1710
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Country | US
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Telephone | 978-935-8032
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Fax |
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Authorized Official
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Title or Position | OWNER, LICSW
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Name | MS. MARY CLOUTER
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Credential | LICSW
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Telephone | 978-942-5455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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