Provider Demographics
NPI:1598451478
Name:WELL BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:WELL BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:PHILLIP
Authorized Official - Last Name:PETRUZZI
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:617-777-6696
Mailing Address - Street 1:301 LITTLETON RD UNIT 857
Mailing Address - Street 2:
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-6044
Mailing Address - Country:US
Mailing Address - Phone:617-777-6696
Mailing Address - Fax:
Practice Address - Street 1:34 COLONIAL DR
Practice Address - Street 2:
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886-4503
Practice Address - Country:US
Practice Address - Phone:617-777-6696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-13
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty