Provider Demographics
NPI:1093386872
Name:SALONIS, THERESA (LMHC)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:SALONIS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 ALDEA AVE
Mailing Address - Street 2:
Mailing Address - City:DUDLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01571-5911
Mailing Address - Country:US
Mailing Address - Phone:774-230-2193
Mailing Address - Fax:
Practice Address - Street 1:21 ALDEA AVE
Practice Address - Street 2:
Practice Address - City:DUDLEY
Practice Address - State:MA
Practice Address - Zip Code:01571-5911
Practice Address - Country:US
Practice Address - Phone:774-230-2193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-02
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5601101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health