Provider Demographics
NPI:1275394785
Name:MINDSET PSYCHIATRIC AND WELLNESS LLC
Entity Type:Organization
Organization Name:MINDSET PSYCHIATRIC AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROSEMONDE
Authorized Official - Middle Name:
Authorized Official - Last Name:PAULO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-632-7575
Mailing Address - Street 1:26 FERRY ST
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:MA
Mailing Address - Zip Code:02149-4925
Mailing Address - Country:US
Mailing Address - Phone:781-632-7565
Mailing Address - Fax:
Practice Address - Street 1:26 FERRY ST
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:MA
Practice Address - Zip Code:02149-4925
Practice Address - Country:US
Practice Address - Phone:781-632-7565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty