TAVERLY JUDE SOUSA (NPI# 1558878264) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558878264 |
| Entity Type | Individual |
| Full Name | TAVERLY JUDE SOUSA |
| Credential | LICSW |
| Practice Address |
33 Pond Ave # B207 Brookline MA 02445-7163 |
| Practice Telephone | 6177390075 |
| Mailing Telephone | 6177390075 |
| Enumeration Date | 2018-01-03 |
| Last Update Date | 2018-01-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
106122 | MA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | LICENSED INDEPENDANT CLINICAL SOCIAL WORKER | 106122 | 01 |
| Street Address |
33 POND AVE # B207 |
| City | BROOKLINE |
| State | MA |
| Zip Code | 02445-7163 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316582117 | Isha Gujrathi | Student in an Organized Health Care Education/Training Program | Center for Evidence Based Imaging, 20 Kent Street, Brookline, MA 02445 | 2019-11-15 |
| 1518432673 | Lois Lange | Social Worker | 349 Clark Road, Brookline, MA 02445 | 2018-10-04 |
| 1548775190 | Neurodevelopmental Educational Services, Pllc | Social Worker | 26 Edgehill Road, Brookline, MA 02445 | 2017-12-05 |
| 1942654231 | Elena Carolina Itriago Araujo | Student in an Organized Health Care Education/Training Program | 358 Tappan St, Brookline, MA 02445 | 2016-04-22 |
| 1477920098 | Kayoko Obara, Dmd PC | Clinic/Center | 77 Pond Ave., #103, Brookline, MA 02445 | 2015-08-31 |
| 1700203668 | Sophie-charlotte Hofferberth | Student in an Organized Health Care Education/Training Program | 93 Evans Road, Brookline, MA 02445 | 2014-03-27 |
| 1639503535 | Kieran Evans | Social Worker | 43 Garrison Road, Brookline, MA 02445 | 2013-08-27 |
| 1437412467 | Joel Simons | Psychologist | 1683 Beacon St, Brookline, MA 02445 | 2012-06-25 |
| 1710252861 | Lin Shen | Internal Medicine | 375 Boylston St, Brookline, MA 02445 | 2012-03-21 |
| 1992074645 | Christine Beatriz Arismendi | Counselor | 16 University Road Apartment 1, Brookline, MA 02445 | 2011-12-27 |
| Find all providers in zip 02445 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063026359 | Melissa Skepko | Counselor | 103 Francis St Unit 2, Brookline, MA 02446-6637 | 2020-09-03 |
| 1649888330 | Fleur De Lis Counseling, Coaching, and Consultation LLC | Counselor | 44 Mason Rd, Brookline, NH 03033-2203 | 2020-07-19 |
| 1376166678 | Amanda Michelle Role | Counselor | 1470 Beacon St Apt B, Brookline, MA 02446-2613 | 2020-05-20 |
| 1902449176 | Xrhealth Usa Inc | Counselor | 1330 Beacon St Ste 209, Brookline, MA 02446-3202 | 2019-10-21 |
| 1730735408 | Brookline Psychologist Pllc | Counselor | 1101 Beacon Street 8w Ste 4, Brookline, MA 02446-0244 | 2019-08-17 |
| 1699331652 | Paul Patrick Thomas | Counselor | 60 Parkman St Apt 2, Brookline, MA 02446-7013 | 2019-05-15 |
| 1821555061 | Karen Katz | Counselor | 222 Pleasant St, Brookline, MA 02446-6855 | 2019-02-25 |
| 1386118198 | Lara Darrow | Counselor | 295 Grassy Brook Rd, Brookline, VT 05345-9744 | 2019-01-15 |
| 1013404466 | Martha S Bullock | Counselor | 30 Park St Apt 1, Brookline, MA 02446-6257 | 2018-04-20 |
| 1275062317 | Lindsey Nicole Keegan | Counselor | 1269 Beacon St Ste 3, Brookline, MA 02446-5248 | 2017-06-11 |
| Find all providers in BROOKLINE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.