Provider Demographics
NPI:1790430270
Name:CENTRAL MASS COUNSELING AND WELLNESS
Entity Type:Organization
Organization Name:CENTRAL MASS COUNSELING AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GRIFF
Authorized Official - Suffix:
Authorized Official - Credentials:LADC-1
Authorized Official - Phone:774-234-6083
Mailing Address - Street 1:164 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:MA
Mailing Address - Zip Code:01522-1469
Mailing Address - Country:US
Mailing Address - Phone:774-234-6083
Mailing Address - Fax:508-267-0434
Practice Address - Street 1:672 MAIN ST
Practice Address - Street 2:
Practice Address - City:HOLDEN
Practice Address - State:MA
Practice Address - Zip Code:01520
Practice Address - Country:US
Practice Address - Phone:774-234-6083
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-14
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty