Provider Demographics
NPI:1083398986
Name:ASIM, ATEEB
Entity Type:Individual
Prefix:
First Name:ATEEB
Middle Name:
Last Name:ASIM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 E NEWTON ST # M912
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-3553
Mailing Address - Country:US
Mailing Address - Phone:617-414-4646
Mailing Address - Fax:
Practice Address - Street 1:85 E NEWTON ST # M912
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-3553
Practice Address - Country:US
Practice Address - Phone:617-414-4646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor