Provider Demographics
NPI:1801609474
Name:SARVENAZ M ASIEDU
Entity type:Organization
Organization Name:SARVENAZ M ASIEDU
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SARVENAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:ASIEDU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-313-2057
Mailing Address - Street 1:877 COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02459-1036
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3 LONNIE LN
Practice Address - Street 2:
Practice Address - City:EDDINGTON
Practice Address - State:ME
Practice Address - Zip Code:04428-3335
Practice Address - Country:US
Practice Address - Phone:617-313-2057
Practice Address - Fax:857-216-8561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty