Organization
GRACEWAY COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW BODANZA LMHC (LICENSED MENTAL HEALTH COUNSELOR)
(978) 410-9184
Entity
Organization
Contact information
Practice address
36 SCHOOL ST, LEOMINSTER, MA 01453-3324
(978) 410-9184
Mailing address
36 SCHOOL ST, LEOMINSTER, MA 01453-3324
(978) 410-9184
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
12/08/2021
Last updated
12/08/2021
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