Basic Information
| Provider Information | |||||||||
| NPI: | 1619696655 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MOSAIC COUNSELING LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 37 SOUTHWICK RD | ||||||||
| Address2: | |||||||||
| City: | NORTH READING | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018642113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6172718981 | ||||||||
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| Practice Location | |||||||||
| Address1: | 37 SOUTHWICK RD | ||||||||
| Address2: | |||||||||
| City: | NORTH READING | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018642113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6172718981 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2022 | ||||||||
| LastUpdateDate: | 08/23/2022 | ||||||||
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| AuthorizedOfficialLastName: | BECK-MILLER | ||||||||
| AuthorizedOfficialFirstName: | ROBIN | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER/THERAPIST | ||||||||
| AuthorizedOfficialTelephone: | 6172718981 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | LMHC | ||||||||
| NPICertificationDate: | 08/23/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.