Doctor Name: | AMY BETH BASILE |
NPI Number: | 1083988331 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHC |
License Number: | 7079 |
Business Practice Address: | 687 Highland Ave 2nd Floor Needham, MA - 024942232 |
Business Phone Number: | 7815598444 |
Business Fax Number: | |
Mailing Address: | 687 Highland Ave, 2nd Floor NEEDHAM |
State: | MA |
Postal Code: | 024942232 |
Phone Number: | 7815598444 |
Fax Number: | |
NPI Enumeration Date: | 03/05/2012 |
NPI Last Update Date: | 03/05/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 7079 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |