Provider Demographics
NPI:1831971472
Name:AUTUMN PSYCHIATRY & COUNSELING
Entity type:Organization
Organization Name:AUTUMN PSYCHIATRY & COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEREDITH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HOGARTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-496-8698
Mailing Address - Street 1:9 CORNERSTONE SQ STE 400B-341
Mailing Address - Street 2:
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-1473
Mailing Address - Country:US
Mailing Address - Phone:978-496-8698
Mailing Address - Fax:
Practice Address - Street 1:9 CORNERSTONE SQ STE 400B-341
Practice Address - Street 2:
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886-1473
Practice Address - Country:US
Practice Address - Phone:978-496-8698
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-18
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty