Provider Demographics
NPI:1194431601
Name:DEHARIYA, SWATI
Entity type:Individual
Prefix:
First Name:SWATI
Middle Name:
Last Name:DEHARIYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 HUNTINGTON AVENUE
Mailing Address - Street 2:1703-88774
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:781-443-8344
Mailing Address - Fax:
Practice Address - Street 1:15 CONSTITUTION ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:MA
Practice Address - Zip Code:01721-1082
Practice Address - Country:US
Practice Address - Phone:857-701-2917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-27
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health