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General NPI Number Information
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NPI Number | 1497993190
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Entity Type | Organization
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Legal Business Name | ACTON COUNSELING ASSOCIATES
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Dates
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Enumeration Date | 02/03/2009
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Last Update Date | 07/27/2023
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Provider Practice Location Address
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Address Line | 110 HAVERHILL RD STE 218
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City | AMESBURY
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State | MA
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Zip | 01913-2149
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Country | US
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Telephone | 978-263-4381
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Fax | 646-219-7109
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Provider Business Mailing Address
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Address Line | 110 HAVERHILL RD STE 218
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City | AMESBURY
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State | MA
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Zip | 01913-2149
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Country | US
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Telephone | 978-263-4381
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Fax | 646-219-7109
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. NICOLE FERRELL CONNOLLY
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Credential | PH D
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Telephone | 978-263-4381
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6277
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License Number State | MA
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