Healthcare Provider Details

I. General information

NPI: 1588590590
Provider Name (Legal Business Name): JUNIPER THERAPY COLLECTIVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 TERRACE RD
NATICK MA
01760-2911
US

IV. Provider business mailing address

57 DUSTIN ST
BRIGHTON MA
02135-2806
US

V. Phone/Fax

Practice location:
  • Phone: 774-270-2856
  • Fax:
Mailing address:
  • Phone: 774-270-2856
  • 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: MR. ALEXANDER HARRIS
Title or Position: CO-OWNER/THERAPIST
Credential: LMHC
Phone: 774-270-2856