Healthcare Provider Details

I. General information

NPI: 1447186515
Provider Name (Legal Business Name): ALYSSA LEWIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 HARRISON AVE STE 230
BOSTON MA
02118-2304
US

IV. Provider business mailing address

30 RUTLAND ST APT 6
BOSTON MA
02118-1512
US

V. Phone/Fax

Practice location:
  • Phone: 617-238-4910
  • Fax:
Mailing address:
  • Phone:
  • 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: