Provider Demographics
NPI:1801377544
Name:CEDAR COUNSELING INC
Entity Type:Organization
Organization Name:CEDAR COUNSELING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MED, LMHC, CADC-II
Authorized Official - Phone:774-454-0581
Mailing Address - Street 1:PO BOX 80471
Mailing Address - Street 2:
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-0005
Mailing Address - Country:US
Mailing Address - Phone:774-454-0581
Mailing Address - Fax:
Practice Address - Street 1:25 CEDAR AVE
Practice Address - Street 2:
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-2420
Practice Address - Country:US
Practice Address - Phone:774-454-0581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9037101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty