Healthcare Provider Details

I. General information

NPI: 1538012505
Provider Name (Legal Business Name): SHORTREAL HEALING CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2026
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

980 MAIN ST APT 34
WOBURN MA
01801-1243
US

IV. Provider business mailing address

980 MAIN ST APT 34
WOBURN MA
01801-1243
US

V. Phone/Fax

Practice location:
  • Phone: 781-537-8227
  • Fax:
Mailing address:
  • Phone: 781-537-8227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: JOHANY ELIZABETH CORTORREAL
Title or Position: OWNER
Credential:
Phone: 646-306-0562