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General NPI Number Information
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NPI Number | 1689529877
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Entity Type | Organization
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Legal Business Name | LANTERN PATH PSYCHOTHERAPY LLC
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Dates
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Enumeration Date | 03/03/2026
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Last Update Date | 03/03/2026
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Provider Practice Location Address
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Address Line | 184 W BOYLSTON ST
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City | WEST BOYLSTON
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State | MA
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Zip | 01583
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Country | US
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Telephone | 415-320-5361
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Fax |
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Provider Business Mailing Address
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Address Line | 436 SOUTHBRIDGE ST STE 2
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City | AUBURN
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State | MA
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Zip | 01501-2442
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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 | OUTPATIENT THERAPIST
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Name | MORGAN SURABIAN
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Credential | LICSW
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Telephone | 415-320-5361
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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