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General NPI Number Information
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NPI Number | 1063002350
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Entity Type | Organization
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Legal Business Name | HEALING WITH TRUST THERAPY, LLC
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Dates
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Enumeration Date | 01/21/2021
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Last Update Date | 01/21/2021
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Provider Practice Location Address
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Address Line | 413 NEPONSET AVE STE 1
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City | BOSTON
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State | MA
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Zip | 02122-3184
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Country | US
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Telephone | 857-445-8167
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Fax |
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Provider Business Mailing Address
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Address Line | 413 NEPONSET AVE STE 1
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City | BOSTON
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State | MA
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Zip | 02122-3184
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Country | US
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Telephone | 857-445-8167
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TAMARA LEROY-LONDON
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Credential | LICSW
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Telephone | 857-445-8167
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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