Healthcare Provider Details

I. General information

NPI: 1992510580
Provider Name (Legal Business Name): MMTHERAPY&CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2025
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4894 SPARKS BLVD
SPARKS NV
89436-8202
US

IV. Provider business mailing address

585 ARMISTICE BLVD
PAWTUCKET RI
02861-2648
US

V. Phone/Fax

Practice location:
  • Phone: 774-253-0104
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MARGARET FREMPONG
Title or Position: OWNER
Credential:
Phone: 774-253-0104