Healthcare Provider Details

I. General information

NPI: 1720207350
Provider Name (Legal Business Name): THERESE MARIE CAHILL LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 PERSEVERANCE WAY
HYANNIS MA
02601-1812
US

IV. Provider business mailing address

26 ROGIA RD
W YARMOUTH MA
02673-8364
US

V. Phone/Fax

Practice location:
  • Phone: 508-862-0600
  • Fax: 508-862-0590
Mailing address:
  • Phone: 508-775-2688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number4964
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: