Provider Demographics
NPI:1467119792
Name:SEXUAL HEALTH AND HEALING LLC
Entity Type:Organization
Organization Name:SEXUAL HEALTH AND HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:WALDRON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:603-566-5414
Mailing Address - Street 1:186 ALEWIFE BROOK PKWY # 1043
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-1121
Mailing Address - Country:US
Mailing Address - Phone:603-566-5414
Mailing Address - Fax:
Practice Address - Street 1:36 SHAWSHEEN RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730-1924
Practice Address - Country:US
Practice Address - Phone:603-566-5414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1174897672OtherNPI