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General NPI Number Information
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NPI Number | 1205979465
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Entity Type | Individual
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Provider Name | CARMEN SASSO LMHC
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Gender | Male
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 265 BEACH ST
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City | REVERE
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State | MA
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Zip | 02151-3131
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Country | US
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Telephone | 617-912-7728
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Fax |
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Provider Business Mailing Address
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Address Line | 92 MARGINAL ST
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City | EAST BOSTON
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State | MA
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Zip | 02128-2715
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 5240
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License Number State | MA
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