Healthcare Provider Details

I. General information

NPI: 1033744396
Provider Name (Legal Business Name): BIANCA GENUALDO LMHC, M.ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2020
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 PUTNAM ST
WINTHROP MA
02152-2902
US

IV. Provider business mailing address

68 WHARF ST
SALEM MA
01970-5151
US

V. Phone/Fax

Practice location:
  • Phone: 617-752-2731
  • Fax:
Mailing address:
  • Phone: 781-248-3156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number512573
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10005918
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number512573
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: