Healthcare Provider Details

I. General information

NPI: 1114747433
Provider Name (Legal Business Name): REFRAME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2024
Last Update Date: 10/11/2024
Certification Date: 10/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 HOWARD ST UNIT 3
WALTHAM MA
02451-4365
US

IV. Provider business mailing address

41 HOWARD ST UNIT 3
WALTHAM MA
02451-4365
US

V. Phone/Fax

Practice location:
  • Phone: 617-351-9711
  • Fax:
Mailing address:
  • Phone: 617-351-9711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL D GUERRA
Title or Position: OWNER
Credential: LMHC
Phone: 617-351-9711