Healthcare Provider Details

I. General information

NPI: 1154253029
Provider Name (Legal Business Name): PRESENT PATH THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 WESTGATE RD
CHESTNUT HILL MA
02467-3409
US

IV. Provider business mailing address

PO BOX 67064
CHESTNUT HILL MA
02467-0001
US

V. Phone/Fax

Practice location:
  • Phone: 860-304-8194
  • Fax:
Mailing address:
  • Phone: 860-304-8194
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: CASSIDY CLARK
Title or Position: OWNER
Credential: LICSW
Phone: 860-304-8194