Healthcare Provider Details

I. General information

NPI: 1558270512
Provider Name (Legal Business Name): JOSEPH MATTHEW KALLMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 MAIN ST
HYANNIS MA
02601-3145
US

IV. Provider business mailing address

66 CANAL ST
BOSTON MA
02114-2002
US

V. Phone/Fax

Practice location:
  • Phone: 833-229-2683
  • Fax:
Mailing address:
  • Phone: 617-371-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: