Healthcare Provider Details

I. General information

NPI: 1477260669
Provider Name (Legal Business Name): ELYSIUM COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2022
Last Update Date: 11/07/2022
Certification Date: 11/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 BEACON ST STE 200
BROOKLINE MA
02446-4819
US

IV. Provider business mailing address

1415 BEACON ST STE 200
BROOKLINE MA
02446-4819
US

V. Phone/Fax

Practice location:
  • Phone: 617-651-3379
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. KAELEY MAJEWSKI
Title or Position: PSYCHOLOGIST
Credential: PSYD
Phone: 617-651-3379