Provider Demographics
NPI:1609374891
Name:THE COUNSELING CENTER AT CELA
Entity Type:Organization
Organization Name:THE COUNSELING CENTER AT CELA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRCTOR
Authorized Official - Prefix:
Authorized Official - First Name:R
Authorized Official - Middle Name:P
Authorized Official - Last Name:O'BRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:617-431-3849
Mailing Address - Street 1:675 VFW PARKWAY #271
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467
Mailing Address - Country:US
Mailing Address - Phone:617-431-3849
Mailing Address - Fax:
Practice Address - Street 1:675 VFW PARKWAY #271
Practice Address - Street 2:
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467
Practice Address - Country:US
Practice Address - Phone:617-431-3849
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-23
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8656101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty