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Taverly Jude Sousa, LICSW
Mental Health Counselor in Brookline, Massachusetts
NPI 1558878264

Taverly Jude Sousa is a Mental Health Counselor based in Brookline, MA and is specialized in Mental Health. Taverly Jude Sousa practices in Brookline, MA and has the professional credentials of LICSW. The NPI Number for Taverly Jude Sousa is 1558878264 and holds a License No. 106122 (Massachusetts).

The current practice location address for Taverly Jude Sousa is 33 Pond Ave # B207, Brookline, MA and can be reached out via phone at 617-739-0075.

Location: 33 Pond Ave # B207, Brookline, MA, 02445-7163
person
Provider Profile Details
NPI Number
1558878264
Provider Name
Taverly Jude Sousa
Credential
LICSW
Provider Entity Type
Individual
Gender
Female
Address
33 Pond Ave # B207, Brookline, MA, 02445-7163
Phone Number
617-739-0075
Fax Number
Provider Enumeration Date
01/03/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
106122 01 MA LICENSED INDEPENDANT CLINICAL SOCIAL WORKER
institution
Provider Business Practice Location Address Details
Address
33 Pond Ave # B207
City
State
Zip
02445-7163
Phone Number
617-739-0075
Fax Number
person
Provider Business Mailing Address Details
Address
33 Pond Ave # B207
City
State
Zip
02445-7163
Phone Number
617-739-0075
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
106122 (Massachusetts)
Definition
Definition to come...
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