Healthcare Provider Details

I. General information

NPI: 1306766514
Provider Name (Legal Business Name): COMMONWEALTH PSYCHOTHERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 DEVONSHIRE ST FL 5
BOSTON MA
02110-1407
US

IV. Provider business mailing address

PO BOX 140365
BOSTON MA
02114-0365
US

V. Phone/Fax

Practice location:
  • Phone: 617-221-3174
  • Fax: 617-706-2603
Mailing address:
  • Phone: 617-221-3174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JULIA AVERNA
Title or Position: PSYCHOTHERAPIST
Credential: LICSW
Phone: 617-221-3174