Provider Demographics
NPI:1881903391
Name:MEETING HOUSE FAMILY COUNSELING
Entity type:Organization
Organization Name:MEETING HOUSE FAMILY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED AGENT/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:A
Authorized Official - Last Name:PENTA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:774-289-4203
Mailing Address - Street 1:947 ROUTE 6A
Mailing Address - Street 2:SUITE 11
Mailing Address - City:YARMOUTH PORT
Mailing Address - State:MA
Mailing Address - Zip Code:02675-2171
Mailing Address - Country:US
Mailing Address - Phone:774-289-4203
Mailing Address - Fax:
Practice Address - Street 1:947 ROUTE 6A
Practice Address - Street 2:SUITE 11
Practice Address - City:YARMOUTH PORT
Practice Address - State:MA
Practice Address - Zip Code:02675-2171
Practice Address - Country:US
Practice Address - Phone:774-289-4203
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-30
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1420101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty