=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417153347
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NEW PASSAGES, P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/26/2007
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 23 MATCHETT STREET
-----------------------------------------------------
City | BRIGHTON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02135
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-729-4010
-----------------------------------------------------
Fax | 781-729-3982
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 573 MAIN ST
-----------------------------------------------------
City | WINCHESTER
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01890-2900
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-729-4010
-----------------------------------------------------
Fax | 781-729-3982
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANGER
-----------------------------------------------------
Name | EILEEN MCCLELLAN
-----------------------------------------------------
Credential | OM
-----------------------------------------------------
Telephone | 781-729-4010
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number | 105911
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 1018803
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 105628
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------