Provider Demographics
NPI:1770871501
Name:NATASHA EDELHAUS ENTERPRISES INC
Entity type:Organization
Organization Name:NATASHA EDELHAUS ENTERPRISES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:EDELHAUS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:781-864-0583
Mailing Address - Street 1:246 WALNUT ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02460-1689
Mailing Address - Country:US
Mailing Address - Phone:617-244-3322
Mailing Address - Fax:617-581-6040
Practice Address - Street 1:756 WASHINGTON ST
Practice Address - Street 2:SUITE B
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-2969
Practice Address - Country:US
Practice Address - Phone:781-864-0583
Practice Address - Fax:781-341-7272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-13
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1274106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty