Healthcare Provider Details

I. General information

NPI: 1578446860
Provider Name (Legal Business Name): MARGARET LOGIE
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 HARTWELL AVE
LEXINGTON MA
02421-3100
US

IV. Provider business mailing address

125 HARTWELL AVE
LEXINGTON MA
02421-3100
US

V. Phone/Fax

Practice location:
  • Phone: 781-861-0890
  • Fax:
Mailing address:
  • Phone: 781-861-0890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN2339348
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: