Provider Demographics
NPI:1245087790
Name:LOVE & MERCY CHRISTIAN COUNSELING SERVICES, INC
Entity type:Organization
Organization Name:LOVE & MERCY CHRISTIAN COUNSELING SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:BERTHONIA
Authorized Official - Last Name:ANTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-828-7447
Mailing Address - Street 1:1424 BLUE HILL AVE
Mailing Address - Street 2:
Mailing Address - City:MATTAPAN
Mailing Address - State:MA
Mailing Address - Zip Code:02126-2277
Mailing Address - Country:US
Mailing Address - Phone:617-828-7447
Mailing Address - Fax:617-296-5552
Practice Address - Street 1:1424 BLUE HILL AVE
Practice Address - Street 2:
Practice Address - City:MATTAPAN
Practice Address - State:MA
Practice Address - Zip Code:02126-2277
Practice Address - Country:US
Practice Address - Phone:617-828-7447
Practice Address - Fax:617-296-5552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty