Provider Demographics
NPI:1497951354
Name:ANAM CARA COUNSELING SVCS
Entity Type:Organization
Organization Name:ANAM CARA COUNSELING SVCS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, BC
Authorized Official - Phone:617-970-4472
Mailing Address - Street 1:424 ADAMS ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-4358
Mailing Address - Country:US
Mailing Address - Phone:617-970-4472
Mailing Address - Fax:617-696-1644
Practice Address - Street 1:36 VINEWOOD RD
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:MA
Practice Address - Zip Code:02186-4838
Practice Address - Country:US
Practice Address - Phone:617-970-4472
Practice Address - Fax:617-696-1644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA173162363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty