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NPI Code Detail

MEDICARE: KATHLEEN GRAVEL LMHC

MEDICARE: KATHLEEN GRAVEL LMHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor7574MA

General Provider Information

NPI Number : 1811313745
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN GRAVEL LMHC
Provider Business Mailing Address
First Line : 15 FULTON ST
Second Line :
City : METHUEN
State : MA
Zip : 01844-7010
Country : US
Telephone Number : 978-430-3249
Fax Number :
Provider Business Practice Location Address
First Line : 99 LORING DR
Second Line :
City : FRAMINGHAM
State : MA
Zip : 01702-8785
Country : US
Telephone Number : 508-532-5100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2014
Last Update Date : 09/07/2016

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Directions to “ KATHLEEN GRAVEL LMHC” Practice Location

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