| Full Name | |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 47 Elm Street, Charlestown, Massachusetts |
| Authorized Official Name and Position | Ellen Jean Sophis Gillespie (OWNER/PSYCHOTHERAPIST) |
| Authorized Official Contact | 6178557633 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
165 Middlesex Avenue #1188 Somerville MA 02145 Ph: (617) 855-7633 | 47 Elm Street Charlestown MA 02129 Ph: (617) 855-7633 |
| NPI Number | 1417596123 |
|---|---|
| Provider Enumeration Date | 12/27/2019 |
| Last Update Date | 01/23/2025 |
| Certification Date | 12/27/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417596123 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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