| Active Balanced Counseling Center, Inc. | |
|
266 Lincoln Rd Walpole MA 02081-1213 | |
| (617) 633-2918 | |
| Not Available |
| Full Name | Active Balanced Counseling Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 266 Lincoln Rd, Walpole, Massachusetts |
| Authorized Official Name and Position | Jayne E Shea (OWNER) |
| Authorized Official Contact | 6176332918 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Active Balanced Counseling Center, Inc. 266 Lincoln Rd Walpole MA 02081-1213 Ph: (617) 633-2918 | Active Balanced Counseling Center, Inc. 266 Lincoln Rd Walpole MA 02081-1213 Ph: (617) 633-2918 |
| NPI Number | 1518533967 |
|---|---|
| Provider Enumeration Date | 05/27/2021 |
| Last Update Date | 05/09/2024 |
| Certification Date | 05/09/2024 |
| Medicare PECOS PAC ID | 5294188009 |
|---|---|
| Medicare Enrollment ID | O20240129001908 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518533967 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Jayne Elizabeth Shea |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760068795 PECOS PAC ID: 6103279914 Enrollment ID: I20240129002701 |
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