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General NPI Number Information
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NPI Number | 1629377536
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Entity Type | Organization
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Legal Business Name | DUXBURY COUNSELING
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Dates
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Enumeration Date | 03/17/2011
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Last Update Date | 03/17/2011
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Provider Practice Location Address
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Address Line | 113 TREMONT STREET
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City | DUXBURY
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State | MA
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Zip | 02332-5117
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Country | US
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Telephone | 781-934-6226
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Fax |
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Provider Business Mailing Address
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Address Line | 301 MARSHALL ST
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City | DUXBURY
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State | MA
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Zip | 02332-5117
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Country | US
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Telephone | 781-452-7207
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Fax |
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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | MRS. MARIE T GOODING
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Credential | LICSW
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Telephone | 781-934-6226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 2029599
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License Number State | MA
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