Provider Demographics
NPI:1811580715
Name:ESSEX COUNTY COUNSELING AND WELLNESS
Entity Type:Organization
Organization Name:ESSEX COUNTY COUNSELING AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORES
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:508-333-7818
Mailing Address - Street 1:PO BOX 404
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-0404
Mailing Address - Country:US
Mailing Address - Phone:508-333-7818
Mailing Address - Fax:
Practice Address - Street 1:145 CABOT ST STE 4
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-5109
Practice Address - Country:US
Practice Address - Phone:978-222-9870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-11
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty