Healthcare Provider Details

I. General information

NPI: 1548175144
Provider Name (Legal Business Name): KELLY CHRISTINA LINO INACIO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 FORDHAM RD
ALLSTON MA
02134-3000
US

IV. Provider business mailing address

36 LITCHFIELD ST APT 3
BRIGHTON MA
02135-1469
US

V. Phone/Fax

Practice location:
  • Phone: 617-782-6460
  • Fax:
Mailing address:
  • Phone: 857-373-9985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: