Provider Demographics
NPI:1689703704
Name:NORTHFIELD COUNSELING ASSOCIATES
Entity Type:Organization
Organization Name:NORTHFIELD COUNSELING ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAMON
Authorized Official - Middle Name:SS
Authorized Official - Last Name:BLANK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-359-6631
Mailing Address - Street 1:5 W MILL ST
Mailing Address - Street 2:#1
Mailing Address - City:MEDFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02052-1554
Mailing Address - Country:US
Mailing Address - Phone:508-359-6631
Mailing Address - Fax:508-359-6631
Practice Address - Street 1:5 W MILL ST
Practice Address - Street 2:#1
Practice Address - City:MEDFIELD
Practice Address - State:MA
Practice Address - Zip Code:02052-1554
Practice Address - Country:US
Practice Address - Phone:508-359-6631
Practice Address - Fax:508-359-6631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALMFT6106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty