Provider Demographics
NPI:1053452060
Name:GATEWAY COUNSELING SERVICES
Entity Type:Organization
Organization Name:GATEWAY COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MELVYN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHNALL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:508-879-7908
Mailing Address - Street 1:5 EDGELL RD
Mailing Address - Street 2:SUITE 24
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-4874
Mailing Address - Country:US
Mailing Address - Phone:508-879-7908
Mailing Address - Fax:508-879-1515
Practice Address - Street 1:5 EDGELL RD
Practice Address - Street 2:SUITE 24
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-4874
Practice Address - Country:US
Practice Address - Phone:508-879-7908
Practice Address - Fax:508-879-1515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1279101YM0800X
MA536103TC0700X
MA2874103TC0700X
MA471106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW10082OtherMEDEX PROVIDER NUMBER
MAW10082Medicare ID - Type UnspecifiedPROVIDER NUMBER