Healthcare Provider Details

I. General information

NPI: 1528683596
Provider Name (Legal Business Name): AVIV, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2020
Last Update Date: 01/12/2026
Certification Date: 01/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 WHEELER STREET
REHOBOTH MA
02769-1101
US

IV. Provider business mailing address

117 WHEELER ST
REHOBOTH MA
02769-1101
US

V. Phone/Fax

Practice location:
  • Phone: 774-231-8008
  • Fax: 774-250-3038
Mailing address:
  • Phone: 774-231-8008
  • Fax: 774-250-3038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: EVA MARIE SMITH
Title or Position: OWNER//COO
Credential: MSOL
Phone: 508-496-1112