Healthcare Provider Details

I. General information

NPI: 1497284046
Provider Name (Legal Business Name): MILAY LEMOS M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2017
Last Update Date: 02/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

694 WESTERN AVE
LYNN MA
01905-2229
US

IV. Provider business mailing address

263 CONCORD AVE
CAMBRIDGE MA
02138-1336
US

V. Phone/Fax

Practice location:
  • Phone: 781-595-7747
  • Fax:
Mailing address:
  • Phone: 617-971-8412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: