Healthcare Provider Details

I. General information

NPI: 1023954765
Provider Name (Legal Business Name): ALAA ATOUI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 WASHINGTON ST
LYNN MA
01904-3306
US

IV. Provider business mailing address

36 WASHINGTON ST
LYNN MA
01904-3306
US

V. Phone/Fax

Practice location:
  • Phone: 781-842-7261
  • Fax:
Mailing address:
  • Phone: 781-842-7261
  • 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: