MEDICARE: JUNIPER THERAPY COLLECTIVE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1588590590
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JUNIPER THERAPY COLLECTIVE LLC

Provider Business Mailing Address
First Line	:	57 DUSTIN ST
Second Line	:
City	:	BRIGHTON
State	:	MA
Zip	:	02135-2806
Country	:	US
Telephone Number	:	774-270-2856
Fax Number	:

Provider Business Practice Location Address
First Line	:	16 TERRACE RD
Second Line	:
City	:	NATICK
State	:	MA
Zip	:	01760-2911
Country	:	US
Telephone Number	:	774-270-2856
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER/THERAPIST
Name	:	MR. ALEXANDER HARRIS
Credential	:	LMHC
Telephone Number	:	774-270-2856

Provider Enumeration Date	:	06/18/2026
Last Update Date	:	06/18/2026

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