Provider Demographics
NPI:1952196024
Name:FENG, TIANMI (MHC)
Entity type:Individual
Prefix:
First Name:TIANMI
Middle Name:
Last Name:FENG
Suffix:
Gender:
Credentials:MHC
Other - Prefix:
Other - First Name:ALISA
Other - Middle Name:
Other - Last Name:FENG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PRE-LMHC
Mailing Address - Street 1:656 OCEAN AVE APT 508
Mailing Address - Street 2:
Mailing Address - City:REVERE
Mailing Address - State:MA
Mailing Address - Zip Code:02151-1461
Mailing Address - Country:US
Mailing Address - Phone:774-688-0094
Mailing Address - Fax:
Practice Address - Street 1:90 EVERETT AVE STE 12
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-2317
Practice Address - Country:US
Practice Address - Phone:857-422-1321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health