Healthcare Provider Details

I. General information

NPI: 1104556596
Provider Name (Legal Business Name): SHEIKA PRITCHARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2022
Last Update Date: 06/16/2022
Certification Date: 06/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

895 BLUE HILL AVE
BOSTON MA
02124-2902
US

IV. Provider business mailing address

92 ARTHUR ST
BROCKTON MA
02302-1803
US

V. Phone/Fax

Practice location:
  • Phone: 617-506-8188
  • Fax:
Mailing address:
  • Phone: 857-202-8679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: