Healthcare Provider Details

I. General information

NPI: 1801303623
Provider Name (Legal Business Name): A NEW APPROACH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2018
Last Update Date: 01/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1017 TURNPIKE ST STE 13
CANTON MA
02021-2828
US

IV. Provider business mailing address

1017 TURNPIKE ST STE 13
CANTON MA
02021-2828
US

V. Phone/Fax

Practice location:
  • Phone: 781-767-7737
  • Fax:
Mailing address:
  • Phone: 781-767-7737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9732
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number409
License Number StateMA

VIII. Authorized Official

Name: MARYELLEN NEWMAN
Title or Position: CLINICIAN/FOUNDER
Credential: LMHC, BCBA, LABA
Phone: 781-767-7737