Provider Demographics
NPI:1437771128
Name:GREATER LOWELL PERSONAL DEVELOPMENT LLC
Entity Type:Organization
Organization Name:GREATER LOWELL PERSONAL DEVELOPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:GIROUX
Authorized Official - Last Name:PEASLEE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:978-455-8242
Mailing Address - Street 1:72 FLORENCE RD
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01851-3504
Mailing Address - Country:US
Mailing Address - Phone:978-455-8242
Mailing Address - Fax:978-735-4586
Practice Address - Street 1:2 COURTHOUSE LN UNIT 10
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-1723
Practice Address - Country:US
Practice Address - Phone:978-455-8242
Practice Address - Fax:978-735-4586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-15
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health