Provider Demographics
NPI:1184291742
Name:COMPREHENSIVE COUNSELING & CONSULTING SERVICES LLC
Entity type:Organization
Organization Name:COMPREHENSIVE COUNSELING & CONSULTING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DORVELUS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:617-639-6968
Mailing Address - Street 1:360 HIGHLAND ST
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-5832
Mailing Address - Country:US
Mailing Address - Phone:617-639-6968
Mailing Address - Fax:
Practice Address - Street 1:360 HIGHLAND ST
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-5832
Practice Address - Country:US
Practice Address - Phone:617-639-6968
Practice Address - Fax:919-364-4797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty