Provider Demographics
NPI:1700444635
Name:ABSTRACT THERAPY LLC.
Entity Type:Organization
Organization Name:ABSTRACT THERAPY LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEVON
Authorized Official - Middle Name:
Authorized Official - Last Name:GOVONI
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, ATR-BC
Authorized Official - Phone:508-591-0372
Mailing Address - Street 1:PO BOX 6054
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02362-6054
Mailing Address - Country:US
Mailing Address - Phone:508-591-0372
Mailing Address - Fax:508-927-8447
Practice Address - Street 1:5 MAIN STREET EXT STE 303
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-3390
Practice Address - Country:US
Practice Address - Phone:508-591-0372
Practice Address - Fax:508-927-8447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-05
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1093003832OtherNPI