Provider Demographics
NPI:1679280846
Name:MY PLACE COUNSELING LLC
Entity Type:Organization
Organization Name:MY PLACE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BREANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:FEROLLA
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:508-686-1338
Mailing Address - Street 1:4 A ST
Mailing Address - Street 2:
Mailing Address - City:HOPKINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01748-1216
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4 A ST
Practice Address - Street 2:
Practice Address - City:HOPKINTON
Practice Address - State:MA
Practice Address - Zip Code:01748-1216
Practice Address - Country:US
Practice Address - Phone:508-686-1338
Practice Address - Fax:508-205-0331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty