MEDICARE: GAIL NUNES LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	388398	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	388398	OTHER	MA	LICENSE

General Provider Information

NPI Number	:	1265917850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GAIL NUNES LMHC

Provider Business Mailing Address
First Line	:	1000 JEFFERSON ST STE 2C
Second Line	:
City	:	LYNCHBURG
State	:	VA
Zip	:	24504-1724
Country	:	US
Telephone Number	:	617-553-4653
Fax Number	:	617-379-0496

Provider Business Practice Location Address
First Line	:	872 MASS AVE STE 2-2
Second Line	:
City	:	CAMBRIDGE
State	:	MA
Zip	:	02139-3072
Country	:	US
Telephone Number	:	617-553-4653
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2018
Last Update Date	:	09/28/2018

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Directions to “ GAIL NUNES LMHC” Practice Location

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