Provider Demographics
NPI:1659731420
Name:NEIGHBORHOOD COUNSELING AND COMMUNITY SERVICES, INC.
Entity Type:Organization
Organization Name:NEIGHBORHOOD COUNSELING AND COMMUNITY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:CATALANO
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LICSW
Authorized Official - Phone:781-600-6074
Mailing Address - Street 1:403 HIGHLAND AVE
Mailing Address - Street 2:SUITE 202, ROOM 5
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02144-2530
Mailing Address - Country:US
Mailing Address - Phone:781-600-6074
Mailing Address - Fax:
Practice Address - Street 1:403 HIGHLAND AVE
Practice Address - Street 2:SUITE 202, ROOM 5
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02144-2530
Practice Address - Country:US
Practice Address - Phone:781-600-6074
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-07
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1030757251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
S100370404Medicare PIN