Provider Demographics
NPI:1477040954
Name:CENTER FOR PERINATAL WELLNESS LLC
Entity Type:Organization
Organization Name:CENTER FOR PERINATAL WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:ELYSE
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LMHC
Authorized Official - Phone:413-626-8958
Mailing Address - Street 1:116 PLEASANT ST STE 335
Mailing Address - Street 2:
Mailing Address - City:EASTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027-2759
Mailing Address - Country:US
Mailing Address - Phone:413-626-8958
Mailing Address - Fax:
Practice Address - Street 1:116 PLEASANT ST STE 335
Practice Address - Street 2:
Practice Address - City:EASTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027-2759
Practice Address - Country:US
Practice Address - Phone:413-626-8958
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-19
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8222101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty