Healthcare Provider Details

I. General information

NPI: 1568010395
Provider Name (Legal Business Name): LEYI ZHU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2019
Last Update Date: 08/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 E NEWTON ST FL 8
BOSTON MA
02118-3553
US

IV. Provider business mailing address

45 E NEWTON ST
BOSTON MA
02118-4802
US

V. Phone/Fax

Practice location:
  • Phone: 617-638-8014
  • Fax:
Mailing address:
  • Phone: 617-331-9219
  • 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: