Healthcare Provider Details

I. General information

NPI: 1588501423
Provider Name (Legal Business Name): MR. AUSTIN HENRY CHINAL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 MERRIMACK ST STE 160
LAWRENCE MA
01843-1780
US

IV. Provider business mailing address

280 MERRIMACK ST STE 160
LAWRENCE MA
01843-1780
US

V. Phone/Fax

Practice location:
  • Phone: 978-806-1298
  • Fax:
Mailing address:
  • Phone: 978-806-1298
  • 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: