MEDICARE: FREDDY LORENZO DOSOUTO

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	:	1598623886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FREDDY LORENZO DOSOUTO

Provider Business Mailing Address
First Line	:	196 HAMILTON ST
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02122-1523
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1127 HARRISON AVE
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02119-3665
Country	:	US
Telephone Number	:	857-237-5167
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2026
Last Update Date	:	01/14/2026

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Directions to “ FREDDY LORENZO DOSOUTO ” Practice Location

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