Breakwater Counseling, LLC
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Gloucester, MA
NPI 1902499155 · NPPES record last updated Feb 18, 2021
Key facts
- NPI
- 1902499155
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- BREAKWATER COUNSELING, LLC
- Practice address
- 2 Main St FL 3
Gloucester, MA 01930-5726 - Phone
- (508) 284-2121
- NPI assigned
- Feb 18, 2021
- Organization subpart
- No
Authorized official
- Name
- Ms. Kristina Michelle Simon, LICSW
- Title
- Mental Health Clinician
- Phone
- (508) 284-2121
Practitioners 1
National Provider Directory
Locations
2 Main St
Fl 3
Gloucester, MA 01930
Phone (978) 290-2976
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes | ||
| Adult Mental Health Clinic/Center | 261QM0850X | |||
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X |
Addresses
Primary practice location
2 Main St FL 3
Gloucester, MA 01930-5726
Mailing address
30 Marble St
Gloucester, MA 01930-4281
Phone (508) 284-2121
Other providers in Gloucester, MA
- Ashley Blodgett
- Alexander Blue
- Jamie D Boghosian
- David J. Bookbinder
- Joseph Borge
- Sheryl M. Brecker
- Sarah Mayne Brennan
- Michael William Bresnan
- Abigaile N Brewer
- Brian Orr Pediatrics LLC
All providers in Gloucester, MA · Mental Health Clinic/Center (Including Community Mental Health Center) in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 18, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.