Provider Demographics
NPI:1548763873
Name:THE MIDDLE PATH LLC
Entity Type:Organization
Organization Name:THE MIDDLE PATH LLC
Other - Org Name:THE MIDDLE PATH, PSYCHOTHERAPY SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LIN-ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHING
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:617-863-6355
Mailing Address - Street 1:661 MASSACHUSETTS AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-5001
Mailing Address - Country:US
Mailing Address - Phone:617-863-6355
Mailing Address - Fax:
Practice Address - Street 1:661 MASSACHUSETTS AVE STE 2
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-5001
Practice Address - Country:US
Practice Address - Phone:617-863-6355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-13
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA113811261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)