| Marblehead Counseling Center Inc | |
|
66 Clifton Ave Marblehead MA 01945 | |
| (781) 631-8273 | |
| (781) 631-7264 |
| Full Name | Marblehead Counseling Center Inc |
|---|---|
| Speciality | Counselor |
| Location | 66 Clifton Ave, Marblehead, Massachusetts |
| Authorized Official Name and Position | Paul Timothy Crosby (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7816318273 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marblehead Counseling Center Inc 66 Clifton Ave Marblehead MA 01945 Ph: (781) 631-8273 | Marblehead Counseling Center Inc 66 Clifton Ave Marblehead MA 01945 Ph: (781) 631-8273 |
| NPI Number | 1205915857 |
|---|---|
| Provider Enumeration Date | 11/03/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 2860464138 |
|---|---|
| Medicare Enrollment ID | O20040807000131 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205915857 | NPI | - | NPPES |
| 1307487 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Provider Name | Marie C Ouellette |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104911007 PECOS PAC ID: 7416904917 Enrollment ID: I20050406001050 |
| Provider Name | Marianne P Magruder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700947223 PECOS PAC ID: 8820045289 Enrollment ID: I20050407000345 |
| Provider Name | Elizabeth Cochran |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669787602 PECOS PAC ID: 5193984003 Enrollment ID: I20120313000693 |
| Provider Name | Gail E Sullivan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861576696 PECOS PAC ID: 8820310295 Enrollment ID: I20141215001119 |
| Provider Name | Philip H West |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114349271 PECOS PAC ID: 0749413300 Enrollment ID: I20210625000194 |
| Provider Name | Liane D. Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841868361 PECOS PAC ID: 8123425261 Enrollment ID: I20210916001131 |
| Provider Name | Garry Long |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841681954 PECOS PAC ID: 6204220643 Enrollment ID: I20220228002137 |
| Provider Name | Katherine Rossi |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912581430 PECOS PAC ID: 2163861451 Enrollment ID: I20240419000624 |
| Provider Name | Nicole Michelle Putur |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487003299 PECOS PAC ID: 0547602260 Enrollment ID: I20240528001149 |
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