Provider Demographics
NPI:1316338783
Name:LTC COUNSELING LLC
Entity type:Organization
Organization Name:LTC COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SIREL
Authorized Official - Middle Name:
Authorized Official - Last Name:TANER-CABALLERO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:978-549-6401
Mailing Address - Street 1:797 WASHINGTON ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02460-1633
Mailing Address - Country:US
Mailing Address - Phone:617-877-0805
Mailing Address - Fax:617-500-4120
Practice Address - Street 1:797 WASHINGTON ST
Practice Address - Street 2:SUITE 4
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02460-1633
Practice Address - Country:US
Practice Address - Phone:617-877-0805
Practice Address - Fax:617-500-4120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-06
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7982101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty