Provider Demographics
NPI:1013555820
Name:MCCOOL PSYCHOTHERAPY LLC
Entity Type:Organization
Organization Name:MCCOOL PSYCHOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCOOL
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:978-885-2278
Mailing Address - Street 1:4 MAPLE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-4166
Mailing Address - Country:US
Mailing Address - Phone:978-885-2278
Mailing Address - Fax:978-685-8233
Practice Address - Street 1:93 MAIN ST STE 213
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-3847
Practice Address - Country:US
Practice Address - Phone:978-885-2278
Practice Address - Fax:978-685-8233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-12
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty