Healthcare Provider Details

I. General information

NPI: 1679414890
Provider Name (Legal Business Name): KASIE FILHO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 NEWBURY ST
DANVERS MA
01923-1087
US

IV. Provider business mailing address

18 ADDISON ST
GLOUCESTER MA
01930-3888
US

V. Phone/Fax

Practice location:
  • Phone: 800-778-5560
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: