Healthcare Provider Details

I. General information

NPI: 1801759261
Provider Name (Legal Business Name): EGO THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 ROSEWOOD DR STE 101
DANVERS MA
01923-4588
US

IV. Provider business mailing address

22 BUXTON ST
PEABODY MA
01960-3118
US

V. Phone/Fax

Practice location:
  • Phone: 978-652-8150
  • Fax:
Mailing address:
  • Phone: 978-652-8150
  • 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: BRUNILDA GJIMARA
Title or Position: CEO
Credential: LICSW
Phone: 978-652-8150