Provider Demographics
NPI:1912565656
Name:MENTAL HEALTH COLLABORATIVE COUNSELING
Entity Type:Organization
Organization Name:MENTAL HEALTH COLLABORATIVE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:NORRMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:508-809-7540
Mailing Address - Street 1:661 WASHINGTON ST STE 301
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-3529
Mailing Address - Country:US
Mailing Address - Phone:508-809-7540
Mailing Address - Fax:508-202-1722
Practice Address - Street 1:661 WASHINGTON ST STE 301
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-3529
Practice Address - Country:US
Practice Address - Phone:508-809-7540
Practice Address - Fax:508-202-1722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty