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General NPI Number Information
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NPI Number | 1093533507
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Entity Type | Organization
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Legal Business Name | KME MHC LLC
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Dates
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Enumeration Date | 10/02/2024
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 160 OLD DERBY ST STE 263
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City | HINGHAM
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State | MA
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Zip | 02043-4064
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Country | US
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Telephone | 781-923-0575
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Fax |
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Provider Business Mailing Address
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Address Line | 92 PLEASANT ST
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City | COHASSET
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State | MA
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Zip | 02025-1706
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Country | US
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Telephone | 617-688-3585
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Fax |
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Authorized Official
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Title or Position | OWNER, MANAGER
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Name | KARYN MURRAY ELLINGER
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Credential | LMHC
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Telephone | 617-688-3585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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