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General NPI Number Information
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NPI Number | 1598677023
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Entity Type | Organization
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Legal Business Name | GREEN VALLEY PSYCHOTHERAPY PLLC
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Dates
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Enumeration Date | 09/21/2026
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Last Update Date | 09/21/2026
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Provider Practice Location Address
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Address Line | 133 LITTLETON RD
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City | HARVARD
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State | MA
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Zip | 01451-1430
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Country | US
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Telephone | 508-826-5926
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Fax | 978-456-8474
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Provider Business Mailing Address
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Address Line | 133 LITTLETON RD
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City | HARVARD
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State | MA
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Zip | 01451-1430
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Country | US
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Telephone | 508-826-5926
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Fax | 978-456-8474
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Authorized Official
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Title or Position | SOLE OWNER
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Name | YHEODORE M JASNOS
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Credential | PHD
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Telephone | 508-826-5926
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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