Individual
ELEONORA ROSE COSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3 LOWE DR, GLOUCESTER, MA 01930-5236
(978) 979-8104
Mailing address
2 CARRIE LN, GLOUCESTER, MA 01930-2328
(978) 979-8104
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LMHC10005524
MA
101YM0800X
Mental Health Counselor
Primary
LMHC10005524
MA
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/02/2017
Last updated
04/20/2026
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