Provider Demographics
NPI:1881977361
Name:SHREWSBURY COUNSELING CENTER, LLC
Entity type:Organization
Organization Name:SHREWSBURY COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:COLE
Authorized Official - Last Name:CAMERER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:508-842-6711
Mailing Address - Street 1:586 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-2920
Mailing Address - Country:US
Mailing Address - Phone:508-842-6711
Mailing Address - Fax:508-842-8429
Practice Address - Street 1:586 MAIN ST
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:MA
Practice Address - Zip Code:01545-2920
Practice Address - Country:US
Practice Address - Phone:508-842-6711
Practice Address - Fax:508-842-8429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA113910101YP2500X
MA5531101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1255513347OtherNPPES
MA1558332536OtherNPPES