Mukandu Ashema
Individual provider Active NPI Counselor · Gardner, MA
NPI 1275370264 · NPPES record last updated Jul 9, 2024
Key facts
- NPI
- 1275370264
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 205 School St
Gardner, MA 01440-2781 - Phone
- (978) 632-9400
- NPI assigned
- Jul 9, 2024
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
205 School St
Gardner, MA 01440-2781
Mailing address
467 Water St # 3R
Fitchburg, MA 01420-7318
Other providers in Gardner, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.