Provider Demographics
NPI:1396200648
Name:MKL COUNSELING & COACHING ASSOCIATES LLC
Entity Type:Organization
Organization Name:MKL COUNSELING & COACHING ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:KATHERINE
Authorized Official - Last Name:LOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:978-241-7881
Mailing Address - Street 1:100 MAIN STREET
Mailing Address - Street 2:SUITE 107
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913
Mailing Address - Country:US
Mailing Address - Phone:978-241-7881
Mailing Address - Fax:978-522-8301
Practice Address - Street 1:100 MAIN STREET
Practice Address - Street 2:SUITE 107
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913
Practice Address - Country:US
Practice Address - Phone:978-241-7881
Practice Address - Fax:978-522-8301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty