Provider Demographics
NPI:1821262189
Name:COMMON GROUND COUNSELING & PERSONAL GROWTH CENTER, LLC
Entity Type:Organization
Organization Name:COMMON GROUND COUNSELING & PERSONAL GROWTH CENTER, LLC
Other - Org Name:JOSEPH F DOWICK
Other - Org Type:Other Name
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:F
Authorized Official - Last Name:DOWICK
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:508-477-3600
Mailing Address - Street 1:22 STEEPLE STREET
Mailing Address - Street 2:SUITE 2053
Mailing Address - City:MASHPEE
Mailing Address - State:MA
Mailing Address - Zip Code:02649
Mailing Address - Country:US
Mailing Address - Phone:508-477-3600
Mailing Address - Fax:508-477-3711
Practice Address - Street 1:22 STEEPLE STREET
Practice Address - Street 2:SUITE 2053
Practice Address - City:MASHPEE
Practice Address - State:MA
Practice Address - Zip Code:02649
Practice Address - Country:US
Practice Address - Phone:508-477-3600
Practice Address - Fax:508-477-3711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1138781041C0700X
MA160572364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGroup - Multi-Specialty