| Brookline Adult And Child Counseling Inc | |
|
1415 Beacon St Ste 306 Brookline MA 02446-4812 | |
| (617) 879-0096 | |
| Not Available |
| Full Name | Brookline Adult And Child Counseling Inc |
|---|---|
| Speciality | Psychologist |
| Location | 1415 Beacon St Ste 306, Brookline, Massachusetts |
| Authorized Official Name and Position | Anika Goldman (OWNER) |
| Authorized Official Contact | 6178790096 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brookline Adult And Child Counseling Inc 1415 Beacon St Ste 306 Brookline MA 02446-4812 Ph: () - | Brookline Adult And Child Counseling Inc 1415 Beacon St Ste 306 Brookline MA 02446-4812 Ph: (617) 879-0096 |
| NPI Number | 1871272286 |
|---|---|
| Provider Enumeration Date | 07/13/2023 |
| Last Update Date | 10/11/2023 |
| Certification Date | 10/11/2023 |
| Medicare PECOS PAC ID | 0840642583 |
|---|---|
| Medicare Enrollment ID | O20240118002806 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871272286 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC2200X | Psychologist - Clinical Child & Adolescent | (* (Not Available)) | Primary |
| Provider Name | Marty Krakowsky |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508812496 PECOS PAC ID: 4789687229 Enrollment ID: I20060823000011 |
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