Provider Demographics
NPI:1609662824
Name:SEVERINO, ESCARLY
Entity type:Individual
Prefix:
First Name:ESCARLY
Middle Name:
Last Name:SEVERINO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 MILTON ST APT 2
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01902-1529
Mailing Address - Country:US
Mailing Address - Phone:617-852-5933
Mailing Address - Fax:
Practice Address - Street 1:8 MILTON ST APT 2
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01902-1529
Practice Address - Country:US
Practice Address - Phone:617-852-5933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health