Doctor Name: | CHARLENE GOREN |
NPI Number: | 1356768972 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHC |
License Number: | |
Business Practice Address: | 357 Main St Athol, MA - 013312233 |
Business Phone Number: | 9788304120 |
Business Fax Number: | 9788304123 |
Mailing Address: | 51 Century Way, GARDNER |
State: | MA |
Postal Code: | 014401268 |
Phone Number: | 6179672194 |
Fax Number: | |
NPI Enumeration Date: | 03/20/2014 |
NPI Last Update Date: | 03/20/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |