Provider Demographics
NPI:1023529203
Name:BEACON COUNSELING SERVICES
Entity type:Organization
Organization Name:BEACON COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE FAMILY THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:VANCE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:978-473-1346
Mailing Address - Street 1:11 BRUCE LN
Mailing Address - Street 2:
Mailing Address - City:WENHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01984-1403
Mailing Address - Country:US
Mailing Address - Phone:978-473-1346
Mailing Address - Fax:
Practice Address - Street 1:140 ELLIOTT ST STE 5
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-3220
Practice Address - Country:US
Practice Address - Phone:978-473-1346
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-16
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1684106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty