Organization
HIDDEN GEMS COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAILEY FASUGBA LMHC, ATR-BC, LADC-1 (OWNER)
(508) 859-9402
Entity
Organization
Contact information
Practice address
6 LIBERTY SQ, PMB 452, BOSTON, MA 02109
(508) 859-9402
(508) 213-3871
Mailing address
6 LIBERTY SQ, PMB 452, BOSTON, MA 02109
(508) 859-9402
(508) 213-3871
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9742
MENTAL HEALTH COUNSELOR LICENSURE
MA
Enumeration date
09/08/2020
Last updated
09/08/2020
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