Provider Demographics
NPI:1164297735
Name:CERVITUDE COALITION INC
Entity Type:Organization
Organization Name:CERVITUDE COALITION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELICA
Authorized Official - Middle Name:
Authorized Official - Last Name:PINNA-PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LICSW, LCAT
Authorized Official - Phone:917-442-4086
Mailing Address - Street 1:97 CENTRAL ST STE 403B
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-1917
Mailing Address - Country:US
Mailing Address - Phone:917-442-4086
Mailing Address - Fax:
Practice Address - Street 1:97 CENTRAL ST STE 403B
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-1917
Practice Address - Country:US
Practice Address - Phone:917-442-4086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-23
Last Update Date:2023-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty