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Organization
THE COUNSELING CENTER OF CHILD DEVELOPMENT, IN
Active
Organization
THE COUNSELING CENTER OF CHILD DEVELOPMENT, IN
Active
Parent organization
CHILD DEVELOPMENT AND EDUCATION, INC.
Other names
The Counseling Center of Child Development and Education, Inc./Child D
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHILD DEVELOPMENT AND EDUCATION, INC.
Authorized official
ANN B. FITZGERALD LICSW (CLINIC DIRECTOR)
(781) 393-5150
Entity
Organization
Contact information
Practice address
10 CABOT ROAD, SUITE 101, MEDFORD, MA 02155
(718) 393-5150
(781) 393-5169
Mailing address
10 CABOT ROAD, SUITE 101, MEDFORD, MA 02155
(781) 393-5150
(781) 393-5169
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
404J
MA
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0015666
MEDICARE
MA
01
—
1031830
BEACON HEALTH STRATEGIES (NHP)
MA
05
—
110081507B
—
MA
01
—
1518164508
MBHP
MA
01
—
288472
TUFTS HEALTH PLAN
MA
01
—
963959-01
NETWORK
MA
Enumeration date
07/02/2007
Last updated
06/01/2012
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