Provider Demographics
NPI:1144003690
Name:KARIN TIERNAN COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:KARIN TIERNAN COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:KARIN
Authorized Official - Middle Name:
Authorized Official - Last Name:TIERNAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LADC I
Authorized Official - Phone:508-789-5637
Mailing Address - Street 1:16 SCONTICUT NECK RD STE 392
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-1914
Mailing Address - Country:US
Mailing Address - Phone:508-789-5637
Mailing Address - Fax:
Practice Address - Street 1:36 ELM AVE
Practice Address - Street 2:
Practice Address - City:FAIRHAVEN
Practice Address - State:MA
Practice Address - Zip Code:02719-6904
Practice Address - Country:US
Practice Address - Phone:508-789-5637
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health