Provider Demographics
NPI:1164973384
Name:ASIEDU, SARVENAZ MOSHFEGH (LMHC)
Entity type:Individual
Prefix:
First Name:SARVENAZ
Middle Name:MOSHFEGH
Last Name:ASIEDU
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 WORCESTER RD
Mailing Address - Street 2:
Mailing Address - City:NEW BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:01531-1824
Mailing Address - Country:US
Mailing Address - Phone:617-313-2057
Mailing Address - Fax:
Practice Address - Street 1:877 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02459-1036
Practice Address - Country:US
Practice Address - Phone:617-313-2057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-24
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC7843101YP2500X
MALMHC10000126101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty