Healthcare Provider Details

I. General information

NPI: 1033799358
Provider Name (Legal Business Name): EVA RAGONESE BA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: E RAGONESE BA

II. Dates (important events)

Enumeration Date: 04/11/2021
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 INNERBELT RD
SOMERVILLE MA
02143-4418
US

IV. Provider business mailing address

17 INNERBELT RD
SOMERVILLE MA
02143-4418
US

V. Phone/Fax

Practice location:
  • Phone: 585-489-9318
  • Fax: 617-629-0010
Mailing address:
  • Phone: 585-489-9318
  • Fax: 617-629-0010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: