Provider Demographics
NPI:1124740493
Name:STEVEN J PELLEGRINE, LMHC LLC
Entity type:Organization
Organization Name:STEVEN J PELLEGRINE, LMHC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:PELLEGRINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-533-1921
Mailing Address - Street 1:10 STEVENS ST UNIT 861
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-3878
Mailing Address - Country:US
Mailing Address - Phone:978-533-1921
Mailing Address - Fax:
Practice Address - Street 1:15 ADAMS CT
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02458-1220
Practice Address - Country:US
Practice Address - Phone:978-533-1921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty