Provider Demographics
NPI:1659822989
Name:NEW BEDFORD COUNSELING GROUP, INC.
Entity Type:Organization
Organization Name:NEW BEDFORD COUNSELING GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-617-3643
Mailing Address - Street 1:306 MOUNT PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02746-1539
Mailing Address - Country:US
Mailing Address - Phone:508-617-3643
Mailing Address - Fax:
Practice Address - Street 1:306 MOUNT PLEASANT ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02746-1539
Practice Address - Country:US
Practice Address - Phone:508-617-3643
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-21
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3752101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty