Provider Demographics
NPI:1952765463
Name:DIVERSE UNDERSTANDING MENTAL HEALTH COUNSELING LLC
Entity Type:Organization
Organization Name:DIVERSE UNDERSTANDING MENTAL HEALTH COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALDO
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:LMHC
Authorized Official - Phone:978-476-9016
Mailing Address - Street 1:95 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-4807
Mailing Address - Country:US
Mailing Address - Phone:978-476-9016
Mailing Address - Fax:
Practice Address - Street 1:160 WINTHROP AVE UNIT 11
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-3840
Practice Address - Country:US
Practice Address - Phone:978-476-9016
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-11
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9504101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA001207271OtherSECRETARY OF THE COMMONWEALTH