Provider Demographics
NPI:1386478220
Name:FLAVIN, EMMA (LMHC)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:FLAVIN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 MISHAWUM RD # F
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-2557
Mailing Address - Country:US
Mailing Address - Phone:508-439-9033
Mailing Address - Fax:
Practice Address - Street 1:58 MISHAWUM RD # F
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-2557
Practice Address - Country:US
Practice Address - Phone:508-439-9033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10001019101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health