Healthcare Provider Details

I. General information

NPI: 1346175130
Provider Name (Legal Business Name): ORGANIZATION NAME: SUNNYSIDE COUNSELING COLLECTIVE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

43 CUMMINS HWY
ROSLINDALE MA
02131-2523
US

IV. Provider business mailing address

43 CUMMINS HWY
ROSLINDALE MA
02131-2523
US

V. Phone/Fax

Practice location:
  • Phone: 617-942-0123
  • Fax:
Mailing address:
  • Phone: 617-942-0123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MOLLY BRIGHAM LICSW
Title or Position: CLINICIAN
Credential: LICSW
Phone: 617-519-0167