Provider Demographics
NPI:1548728520
Name:GENNEW
Entity type:Organization
Organization Name:GENNEW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THADDIEUS
Authorized Official - Middle Name:M
Authorized Official - Last Name:SARPY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LMHC
Authorized Official - Phone:857-293-5020
Mailing Address - Street 1:30 EASTBROOK RD STE 101
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-2083
Mailing Address - Country:US
Mailing Address - Phone:857-293-5020
Mailing Address - Fax:
Practice Address - Street 1:30 EASTBROOK RD STE 101
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-2083
Practice Address - Country:US
Practice Address - Phone:857-293-5020
Practice Address - Fax:857-226-8772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-07
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty