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General NPI Number Information
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NPI Number | 1962833863
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Entity Type | Organization
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Legal Business Name | PUZZLE PIECES, LLC
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Dates
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Enumeration Date | 12/03/2013
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 1266 FURNACE BROOK PKWY STE 100B
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City | QUINCY
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State | MA
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Zip | 02169-4789
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Country | US
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Telephone | 617-433-7699
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Fax | 617-481-2325
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Provider Business Mailing Address
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Address Line | 1266 FURNACE BROOK PKWY STE 100B
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City | QUINCY
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State | MA
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Zip | 02169-4789
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Country | US
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Telephone | 617-433-7699
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Fax | 617-481-2325
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Authorized Official
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Title or Position | CLINICAL DIRECTOR/PARTNER
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Name | MEGAN SHEA SELCHAN
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Credential |
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Telephone | 617-890-1060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 8546
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 8947
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 7307
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License Number State | MA
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