NPIMap

Organization Active NPI

Graceway Counseling, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Leominster, MA
National Provider Identifier
1295493195
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
GRACEWAY COUNSELING, LLC
Practice address
36 School St
Leominster, MA 01453-3324
Phone
(978) 410-9184
NPI assigned
Dec 8, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Matthew Bodanza, LMHCNPI 1801343959
Title
Licensed Mental Health Counselor
Phone
(978) 410-9184

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

36 School St
Leominster, MA 01453-3324

Mailing address

36 School St
Leominster, MA 01453-3324
Phone (978) 410-9184

National Provider Directory

National Provider Directory

Locations

36 School St
Leominster, MA 01453
Phone (978) 410-9184

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638921600000",
    "number": "1295493195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 SCHOOL ST",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014533324",
            "telephone_number": "978-410-9184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 SCHOOL ST",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014533324",
            "telephone_number": "978-410-9184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACEWAY COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-08",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A",
        "authorized_official_last_name": "BODANZA",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "LICENSED MENTAL HEALTH COUNSELOR",
        "authorized_official_telephone_number": "978-410-9184",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leominster, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.