Healthcare Provider Details

I. General information

NPI: 1831974237
Provider Name (Legal Business Name): LARA FINKS M.ED., SAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2023
Last Update Date: 08/25/2023
Certification Date: 08/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 TABER ST APT 206
BOSTON MA
02119-4148
US

IV. Provider business mailing address

10 TABER ST APT 206
BOSTON MA
02119-4148
US

V. Phone/Fax

Practice location:
  • Phone: 617-962-7834
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number400435
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number400435
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number400435
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: