Provider Demographics
NPI:1306430871
Name:NEPONSET THERAPY ASSOCIATES, LLC
Entity type:Organization
Organization Name:NEPONSET THERAPY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CHELSEY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:O'DONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:617-872-0395
Mailing Address - Street 1:97 MOUNT IDA RD APT 3
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02122-1977
Mailing Address - Country:US
Mailing Address - Phone:617-872-0395
Mailing Address - Fax:
Practice Address - Street 1:1266 FURNACE BROOK PKWY STE 103B
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-4785
Practice Address - Country:US
Practice Address - Phone:781-570-3530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-25
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health