Provider Demographics
NPI:1801463963
Name:SEVENTEEN MOUNTAINS THERAPY, LLC
Entity type:Organization
Organization Name:SEVENTEEN MOUNTAINS THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLEE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANEL
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:860-581-3536
Mailing Address - Street 1:16 OAK ST
Mailing Address - Street 2:
Mailing Address - City:DUNSTABLE
Mailing Address - State:MA
Mailing Address - Zip Code:01827-1615
Mailing Address - Country:US
Mailing Address - Phone:860-581-3536
Mailing Address - Fax:
Practice Address - Street 1:16 OAK ST
Practice Address - Street 2:
Practice Address - City:DUNSTABLE
Practice Address - State:MA
Practice Address - Zip Code:01827-1615
Practice Address - Country:US
Practice Address - Phone:860-581-3536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health