Healthcare Provider Details

I. General information

NPI: 1134042088
Provider Name (Legal Business Name): ONE HEART COUNSELING & CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1539 BLUE HILL AVE STE 10
MATTAPAN MA
02126-2124
US

IV. Provider business mailing address

1539 BLUE HILL AVE STE 10
MATTAPAN MA
02126-2124
US

V. Phone/Fax

Practice location:
  • Phone: 508-510-4960
  • Fax:
Mailing address:
  • Phone: 508-510-4960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. CAROLYN HENDERSON
Title or Position: MENTAL HEALTH THERAPIST
Credential: LMHC
Phone: 508-510-4960