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NPI Code Detail

MEDICARE: HALEY ANNE VRADENBURG LMHC

MEDICARE: HALEY ANNE VRADENBURG LMHC
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
1101YM0800XMental Health CounselorLMHC10005380MA

General Provider Information

NPI Number : 1649886912
Entity Type Code : Individual
Provider Name (Legal Business Name) : HALEY ANNE VRADENBURG LMHC
Provider Business Mailing Address
First Line : 91 OAKLAND AVE
Second Line :
City : QUINCY
State : MA
Zip : 02170-3738
Country : US
Telephone Number : 781-296-6002
Fax Number :
Provider Business Practice Location Address
First Line : 1501 WASHINGTON ST
Second Line :
City : BRAINTREE
State : MA
Zip : 02184-7599
Country : US
Telephone Number : 857-344-4394
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2020
Last Update Date : 01/09/2026

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