Provider Demographics
NPI:1689236283
Name:PHILOSOPHE-GERSHFIELD, TALLY MARCELLE (LMHC)
Entity Type:Individual
Prefix:
First Name:TALLY
Middle Name:MARCELLE
Last Name:PHILOSOPHE-GERSHFIELD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:TALLY
Other - Middle Name:M
Other - Last Name:GERSHFIELD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:10 ESTY FARM RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02459-3607
Mailing Address - Country:US
Mailing Address - Phone:617-895-6229
Mailing Address - Fax:
Practice Address - Street 1:10 ESTY FARM RD
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02459-3607
Practice Address - Country:US
Practice Address - Phone:617-895-6229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-03
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MALMHC10001031101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health