Provider Demographics
NPI:1023621414
Name:MANTRA MENTAL HEALTH COUNSELING LLC
Entity type:Organization
Organization Name:MANTRA MENTAL HEALTH COUNSELING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER & LMHC
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:617-545-4969
Mailing Address - Street 1:4 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:MEDWAY
Mailing Address - State:MA
Mailing Address - Zip Code:02053-1623
Mailing Address - Country:US
Mailing Address - Phone:617-545-4969
Mailing Address - Fax:617-608-1962
Practice Address - Street 1:4 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:MEDWAY
Practice Address - State:MA
Practice Address - Zip Code:02053-1623
Practice Address - Country:US
Practice Address - Phone:617-564-3281
Practice Address - Fax:617-608-1962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-26
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty