Healthcare Provider Details

I. General information

NPI: 1598453946
Provider Name (Legal Business Name): SAMEEM BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2023
Last Update Date: 01/19/2024
Certification Date: 01/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 LINCOLN ST
NEWTON HIGHLANDS MA
02461-1507
US

IV. Provider business mailing address

34 LINCOLN ST
NEWTON HIGHLANDS MA
02461-1507
US

V. Phone/Fax

Practice location:
  • Phone: 617-964-1060
  • Fax: 617-630-0381
Mailing address:
  • Phone: 617-964-1060
  • Fax: 617-630-0381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES E REYNOLDS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 617-964-1060