Provider Demographics
NPI:1861919755
Name:HEALTHY-SELF COUNSELING, LLC
Entity type:Organization
Organization Name:HEALTHY-SELF COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSTON
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, LADC1
Authorized Official - Phone:508-802-4199
Mailing Address - Street 1:PO BOX 1248
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02048-5248
Mailing Address - Country:US
Mailing Address - Phone:508-802-4199
Mailing Address - Fax:508-321-9428
Practice Address - Street 1:1133 PLEASANT ST UNIT A
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02324-2214
Practice Address - Country:US
Practice Address - Phone:508-802-4199
Practice Address - Fax:508-321-9428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-23
Last Update Date:2020-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2366101YA0400X
MA8154101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty