Provider Demographics
NPI:1962833863
Name:PUZZLE PIECES, LLC
Entity Type:Organization
Organization Name:PUZZLE PIECES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:SHEA
Authorized Official - Last Name:SELCHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-890-1060
Mailing Address - Street 1:1266 FURNACE BROOK PKWY STE 100B
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-4789
Mailing Address - Country:US
Mailing Address - Phone:617-433-7699
Mailing Address - Fax:617-481-2325
Practice Address - Street 1:1266 FURNACE BROOK PKWY STE 100B
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-4789
Practice Address - Country:US
Practice Address - Phone:617-433-7699
Practice Address - Fax:617-481-2325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7307101YM0800X
MA8546101YM0800X
225XP0200X
MA8947235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty