Provider Demographics
NPI:1417653098
Name:THE HAPPY MIRROR
Entity Type:Organization
Organization Name:THE HAPPY MIRROR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MALAVIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHATTERJEE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:857-334-3034
Mailing Address - Street 1:2000 MASSACHUSETTS AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-2100
Mailing Address - Country:US
Mailing Address - Phone:857-334-3036
Mailing Address - Fax:
Practice Address - Street 1:2000 MASSACHUSETTS AVE STE 4
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02140-2100
Practice Address - Country:US
Practice Address - Phone:857-334-3034
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-06
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health