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Organization

SEASIDE COUNSELING, LLC

Active
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Organization

SEASIDE COUNSELING, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
COURTNEY H WILSON LICSW (CO OWNER)
(978) 852-8042
Entity
Organization

Contact information

Practice address
85 EASTERN AVE, SUITE G102, GLOUCESTER, MA 01930-6512
(978) 852-8042
Mailing address
85 EASTERN AVE, SUITE G102, GLOUCESTER, MA 01930-6512
(978) 852-8042

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
215746
MA
1041C0700X
Clinical Social Worker
Primary
111091
MA

Other

Enumeration date
12/04/2009
Last updated
12/04/2009
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