Provider Demographics
NPI:1093209769
Name:SALERNO PSYCHOTHERAPY LLC
Entity type:Organization
Organization Name:SALERNO PSYCHOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPSIT
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SALERNO
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:617-448-8063
Mailing Address - Street 1:59 CROSS ST
Mailing Address - Street 2:
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-3145
Mailing Address - Country:US
Mailing Address - Phone:617-448-8063
Mailing Address - Fax:
Practice Address - Street 1:80 WASHINGTON ST STE C17
Practice Address - Street 2:
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-1729
Practice Address - Country:US
Practice Address - Phone:617-448-8063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-18
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA115658104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0019793Medicaid