Provider Demographics
NPI:1871240051
Name:RE-ANCHORED THERAPY
Entity Type:Organization
Organization Name:RE-ANCHORED THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:C
Authorized Official - Last Name:SULTAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:617-657-4125
Mailing Address - Street 1:377 WILLARD ST # 302
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-6122
Mailing Address - Country:US
Mailing Address - Phone:774-826-7528
Mailing Address - Fax:
Practice Address - Street 1:8 WALNUT ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02171-1700
Practice Address - Country:US
Practice Address - Phone:774-826-7528
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth ServiceGroup - Single Specialty