Provider Demographics
NPI:1841860020
Name:COMPREHENSIVE COUNSELING LCSW PLLC
Entity type:Organization
Organization Name:COMPREHENSIVE COUNSELING LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PAYOR AND PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLYE
Authorized Official - Middle Name:
Authorized Official - Last Name:HICKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-645-2034
Mailing Address - Street 1:2 MAIN ST STE 2A
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-8325
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2 MAIN ST STE 2A
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-8325
Practice Address - Country:US
Practice Address - Phone:718-830-0246
Practice Address - Fax:718-830-9088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty