Provider Demographics
NPI:1659140697
Name:HARBORSIDE COUNSELING LLC
Entity Type:Organization
Organization Name:HARBORSIDE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HEFFRON
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:774-269-7707
Mailing Address - Street 1:225 WATER ST STE A200
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-4079
Mailing Address - Country:US
Mailing Address - Phone:774-269-7707
Mailing Address - Fax:
Practice Address - Street 1:225 WATER ST STE A200
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4079
Practice Address - Country:US
Practice Address - Phone:774-269-7707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-01
Last Update Date:2024-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty