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General NPI Number Information
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NPI Number | 1013592179
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Entity Type | Organization
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Legal Business Name | CERVITUDE COUNSELING PLLC
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Dates
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Enumeration Date | 03/10/2021
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Last Update Date | 11/23/2023
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Provider Practice Location Address
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Address Line | 97 CENTRAL ST STE 403B
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City | LOWELL
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State | MA
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Zip | 01852-1917
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Country | US
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Telephone | 617-996-8119
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Fax | 617-925-6367
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Provider Business Mailing Address
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Address Line | 219 CENTRAL ST APT 4E
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City | LOWELL
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State | MA
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Zip | 01852-2215
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Country | US
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Telephone | 617-996-8119
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANGELICA PINNA-PEREZ
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Credential | PHD, LICSW
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Telephone | 617-996-8119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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