Healthcare Provider Details

I. General information

NPI: 1598677023
Provider Name (Legal Business Name): GREEN VALLEY PSYCHOTHERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 LITTLETON RD
HARVARD MA
01451-1430
US

IV. Provider business mailing address

133 LITTLETON RD
HARVARD MA
01451-1430
US

V. Phone/Fax

Practice location:
  • Phone: 508-826-5926
  • Fax: 978-456-8474
Mailing address:
  • Phone: 508-826-5926
  • Fax: 978-456-8474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: YHEODORE M JASNOS
Title or Position: SOLE OWNER
Credential: PHD
Phone: 508-826-5926