Provider Demographics
NPI:1912464603
Name:STOUGHTON COUNSELING INC
Entity Type:Organization
Organization Name:STOUGHTON COUNSELING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:COSTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-290-2795
Mailing Address - Street 1:1044 CENTRAL ST STE 202
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-4423
Mailing Address - Country:US
Mailing Address - Phone:617-379-0496
Mailing Address - Fax:781-341-4489
Practice Address - Street 1:1044 CENTRAL ST STE 202
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-4423
Practice Address - Country:US
Practice Address - Phone:781-318-8080
Practice Address - Fax:617-379-0496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-28
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty