Provider Demographics
NPI:1770244360
Name:LAUREL RIVER COUNSELING LLC
Entity Type:Organization
Organization Name:LAUREL RIVER COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAUROY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-793-3481
Mailing Address - Street 1:25 OMOORE AVE
Mailing Address - Street 2:
Mailing Address - City:MAYNARD
Mailing Address - State:MA
Mailing Address - Zip Code:01754-1936
Mailing Address - Country:US
Mailing Address - Phone:789-793-3481
Mailing Address - Fax:
Practice Address - Street 1:25 STOW RD UNIT B
Practice Address - Street 2:
Practice Address - City:BOXBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01719-1845
Practice Address - Country:US
Practice Address - Phone:978-793-3481
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-05
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health