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General NPI Number Information
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NPI Number | 1689445488
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Entity Type | Organization
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Legal Business Name | MEADOWBROOK COUNSELING OF MASSACHUSETTS, LLC
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Dates
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Enumeration Date | 01/10/2024
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Last Update Date | 08/06/2024
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Provider Practice Location Address
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Address Line | 34 MAIN STREET EXT STE 104
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City | PLYMOUTH
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State | MA
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Zip | 02360-3375
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Country | US
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Telephone | 801-655-5450
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Fax |
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Provider Business Mailing Address
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Address Line | 1469 N 1200 W
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City | OREM
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State | UT
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Zip | 84057-2449
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | WHITNEY HEBBERT
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Credential | LMFT
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Telephone | 801-655-5450
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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