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General NPI Number Information
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NPI Number | 1497951354
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Entity Type | Organization
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Legal Business Name | ANAM CARA COUNSELING SVCS
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Dates
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Enumeration Date | 06/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 36 VINEWOOD RD
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City | MILTON
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State | MA
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Zip | 02186-4838
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Country | US
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Telephone | 617-970-4472
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Fax | 617-696-1644
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Provider Business Mailing Address
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Address Line | 424 ADAMS ST SUITE 202
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City | MILTON
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State | MA
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Zip | 02186-4358
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Country | US
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Telephone | 617-970-4472
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Fax | 617-696-1644
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MARY ELLEN SMITH
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Credential | APRN, BC
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Telephone | 617-970-4472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 173162
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License Number State | MA
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