Provider Demographics
NPI:1467097618
Name:COUNSELING IN THE SQUARE
Entity Type:Organization
Organization Name:COUNSELING IN THE SQUARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:SOLEDAD
Authorized Official - Last Name:HIRALDO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:617-684-5257
Mailing Address - Street 1:23 DOW ST
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02144-1502
Mailing Address - Country:US
Mailing Address - Phone:305-467-5656
Mailing Address - Fax:
Practice Address - Street 1:61 ROSELAND ST STE 2
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-3536
Practice Address - Country:US
Practice Address - Phone:617-684-5256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-12
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty