=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982318788
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FIRPO GREENWOOD MENTAL HEALTH COUNSELING LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/06/2023
-----------------------------------------------------
Last Update Date | 02/04/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 80 WASHINGTON ST STE C17
-----------------------------------------------------
City | NORWELL
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02061-1729
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-202-1969
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6 LIBERTY SQ PMB 95603
-----------------------------------------------------
City | BOSTON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02109-5800
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-202-0604
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/THERAPIST
-----------------------------------------------------
Name | MRS. YENILSHIA LISELY FIRPO-GREENWOOD
-----------------------------------------------------
Credential | LICSW
-----------------------------------------------------
Telephone | 508-202-0604
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------