Healthcare Provider Details

I. General information

NPI: 1790375202
Provider Name (Legal Business Name): OTHERWISE PSYCHOTHERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2021
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

678 MASSACHUSETTS AVE STE 802
CAMBRIDGE MA
02139-3363
US

IV. Provider business mailing address

678 MASSACHUSETTS AVE STE 802
CAMBRIDGE MA
02139-3363
US

V. Phone/Fax

Practice location:
  • Phone: 774-563-3466
  • Fax:
Mailing address:
  • Phone: 774-563-3466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: NATE TORRENCE
Title or Position: OWNER
Credential: LMHC
Phone: 774-563-3466