Healthcare Provider Details

I. General information

NPI: 1992618003
Provider Name (Legal Business Name): ANASTASIA YANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 ELECTRIC AVE STE 204
FITCHBURG MA
01420-7954
US

IV. Provider business mailing address

33 ELECTRIC AVE STE 204
FITCHBURG MA
01420-7954
US

V. Phone/Fax

Practice location:
  • Phone: 978-345-9400
  • Fax: 978-345-9411
Mailing address:
  • Phone: 978-345-9400
  • Fax: 978-345-9411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: