Provider Demographics
NPI:1073703807
Name:SEGWANYI, KASIRYE (MA)
Entity Type:Individual
Prefix:MR
First Name:KASIRYE
Middle Name:
Last Name:SEGWANYI
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 FOREST ACRES DR
Mailing Address - Street 2:APT H
Mailing Address - City:BRADFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01835-8609
Mailing Address - Country:US
Mailing Address - Phone:617-240-1083
Mailing Address - Fax:
Practice Address - Street 1:3 COURTHOUSE LN
Practice Address - Street 2:SUITE 3
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-1722
Practice Address - Country:US
Practice Address - Phone:978-256-1444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor