Provider Demographics
NPI:1245098722
Name:BLUE WORLD COUNSELING
Entity type:Organization
Organization Name:BLUE WORLD COUNSELING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAVEL
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:508-202-0741
Mailing Address - Street 1:227 UNION ST STE 408
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-5946
Mailing Address - Country:US
Mailing Address - Phone:508-202-0741
Mailing Address - Fax:
Practice Address - Street 1:227 UNION ST STE 408
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-5946
Practice Address - Country:US
Practice Address - Phone:508-202-0741
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-11
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center