Healthcare Provider Details

I. General information

NPI: 1982915591
Provider Name (Legal Business Name): THELM, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2010
Last Update Date: 06/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1234 BROADWAY
SOMERVILLE MA
02144-1703
US

IV. Provider business mailing address

95 PARKER ST
NEWBURYPORT MA
01950-4033
US

V. Phone/Fax

Practice location:
  • Phone: 617-863-0833
  • Fax: 617-776-0964
Mailing address:
  • Phone: 978-225-2250
  • Fax: 978-225-2251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number113662
License Number StateMA

VIII. Authorized Official

Name: EDWARD TED HELM
Title or Position: OWNER
Credential:
Phone: 617-863-0833