Healthcare Provider Details

I. General information

NPI: 1346819505
Provider Name (Legal Business Name): HALLIE GORICA PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HALLIE BAUGHER

II. Dates (important events)

Enumeration Date: 06/22/2021
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 LONGWOOD AVE
BOSTON MA
02115-5724
US

IV. Provider business mailing address

300 LONGWOOD AVE
BOSTON MA
02115-5724
US

V. Phone/Fax

Practice location:
  • Phone: 617-355-6000
  • Fax:
Mailing address:
  • Phone: 617-355-6000
  • Fax: 804-327-3065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0039308
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN10005567
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: