Provider Demographics
NPI:1952628919
Name:KAINEJAD, SIMA (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:SIMA
Middle Name:
Last Name:KAINEJAD
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125A OXFORD ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-2251
Mailing Address - Country:US
Mailing Address - Phone:617-417-0458
Mailing Address - Fax:
Practice Address - Street 1:125A OXFORD ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02140-2251
Practice Address - Country:US
Practice Address - Phone:617-417-0458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-29
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7551101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health