Provider Demographics
NPI:1316565005
Name:MDS COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:MDS COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:DE SEDAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-615-7420
Mailing Address - Street 1:186 ALEWIFE BROOK PKWY # 1019
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-1121
Mailing Address - Country:US
Mailing Address - Phone:202-615-7420
Mailing Address - Fax:
Practice Address - Street 1:186 ALEWIFE BROOK PKWY # 1019
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-1121
Practice Address - Country:US
Practice Address - Phone:202-615-7420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-08
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health