| Seaside Counseling, Llc | |
|
85 Eastern Ave Suite G102 Gloucester MA 01930-6512 | |
| (978) 852-8042 | |
| Not Available |
| Full Name | Seaside Counseling, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 85 Eastern Ave, Gloucester, Massachusetts |
| Authorized Official Name and Position | Courtney H Wilson (CO OWNER) |
| Authorized Official Contact | 9788528042 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Seaside Counseling, Llc 85 Eastern Ave Suite G102 Gloucester MA 01930-6512 Ph: (978) 852-8042 | Seaside Counseling, Llc 85 Eastern Ave Suite G102 Gloucester MA 01930-6512 Ph: (978) 852-8042 |
| NPI Number | 1073841995 |
|---|---|
| Provider Enumeration Date | 12/04/2009 |
| Last Update Date | 12/04/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073841995 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | 215746 (Massachusetts) | Secondary |
| 1041C0700X | Social Worker - Clinical | 111091 (Massachusetts) | Primary |
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