Provider Demographics
NPI:1629377536
Name:DUXBURY COUNSELING
Entity type:Organization
Organization Name:DUXBURY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:T
Authorized Official - Last Name:GOODING
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:781-934-6226
Mailing Address - Street 1:301 MARSHALL ST
Mailing Address - Street 2:
Mailing Address - City:DUXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02332-5117
Mailing Address - Country:US
Mailing Address - Phone:781-452-7207
Mailing Address - Fax:
Practice Address - Street 1:113 TREMONT STREET
Practice Address - Street 2:
Practice Address - City:DUXBURY
Practice Address - State:MA
Practice Address - Zip Code:02332-5117
Practice Address - Country:US
Practice Address - Phone:781-934-6226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-17
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2029599251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health