Healthcare Provider Details

I. General information

NPI: 1336870864
Provider Name (Legal Business Name): FIRST-CLASS BEHAVIORAL & COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2022
Last Update Date: 07/27/2023
Certification Date: 07/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1017 TURNPIKE ST UNITS 31A, 32A ,33
CANTON MA
02021
US

IV. Provider business mailing address

1017 TURNPIKE ST UNITS 32A & 33
CANTON MA
02021
US

V. Phone/Fax

Practice location:
  • Phone: 781-236-7343
  • Fax: 781-806-1026
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: YVEDA BRUTUS
Title or Position: OWNER
Credential: PMHNP
Phone: 857-719-6538