Healthcare Provider Details

I. General information

NPI: 1841095312
Provider Name (Legal Business Name): ZIJIN LI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2025
Last Update Date: 02/18/2025
Certification Date: 02/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 E NEWTON ST STE 1
BOSTON MA
02118-3554
US

IV. Provider business mailing address

1505 COMMONWEALTH AVE UNIT 302
BRIGHTON MA
02135-3605
US

V. Phone/Fax

Practice location:
  • Phone: 617-414-8336
  • Fax:
Mailing address:
  • Phone: 95-196-1332
  • 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: