Healthcare Provider Details

I. General information

NPI: 1922766732
Provider Name (Legal Business Name): EMILY LUNARDI LMHC, RDT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2021
Last Update Date: 03/05/2022
Certification Date: 03/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1842 BEACON ST STE 202
BROOKLINE MA
02445-1922
US

IV. Provider business mailing address

18 IRMA AVE APT 1
WATERTOWN MA
02472-3589
US

V. Phone/Fax

Practice location:
  • Phone: 610-742-1741
  • Fax:
Mailing address:
  • Phone: 610-742-1741
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101200000X
TaxonomyDrama Therapist
License Number770
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number12772
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: