Provider Demographics
NPI:1336870864
Name:FIRST-CLASS BEHAVIORAL & COUNSELING SERVICES
Entity Type:Organization
Organization Name:FIRST-CLASS BEHAVIORAL & COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YVEDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUTUS
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:857-719-6538
Mailing Address - Street 1:1017 TURNPIKE ST
Mailing Address - Street 2:UNITS 32A & 33
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1017 TURNPIKE ST
Practice Address - Street 2:UNITS 31A, 32A ,33
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021
Practice Address - Country:US
Practice Address - Phone:781-236-7343
Practice Address - Fax:781-806-1026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-24
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty