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NPI Code Detail

MEDICARE: ERIN ROSE MANGAN

MEDICARE: ERIN ROSE MANGAN
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 Counselor

General Provider Information

NPI Number : 1720917297
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIN ROSE MANGAN
Provider Business Mailing Address
First Line : 1125 CENTRE ST
Second Line :
City : JAMAICA PLAIN
State : MA
Zip : 02130-3495
Country : US
Telephone Number : 617-524-3116
Fax Number :
Provider Business Practice Location Address
First Line : 1125 CENTRE ST
Second Line :
City : JAMAICA PLAIN
State : MA
Zip : 02130-3495
Country : US
Telephone Number : 617-524-3116
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2026
Last Update Date : 05/19/2026

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Directions to “ ERIN ROSE MANGAN ” Practice Location

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