=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649475575
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ARLINGTON COUNSELING ASSOCIATES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/20/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7 CENTRAL ST SUITE 222
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02476-4800
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-641-4100
-----------------------------------------------------
Fax | 781-641-4101
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7 CENTRAL ST SUITE 222
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02476-4800
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-641-4100
-----------------------------------------------------
Fax | 781-641-4101
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. ROBERT COHEN
-----------------------------------------------------
Credential | LICSW
-----------------------------------------------------
Telephone | 781-641-4100
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 102821
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------