Organization Name: | MIND MATTERS THERAPY, LLC |
NPI Number: | 1407110067 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHELLE L CHUNIS (OWNER) |
Mailing Address: | 354 W Boylston St Suite 225 West Boylston |
State: | MA US |
Postal Code: | 015832373 |
Phone Number: | 5088524800 |
Fax Number: | |
NPI Enumeration Date: | 06/28/2012 |
NPI Last Update Date: | 06/28/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 113193 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |