Provider Demographics
NPI:1659724607
Name:FAMILY & EDUCATIONAL WELLNESS CENTER
Entity Type:Organization
Organization Name:FAMILY & EDUCATIONAL WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NADJA
Authorized Official - Middle Name:NOREEN
Authorized Official - Last Name:REILLY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:617-922-2797
Mailing Address - Street 1:500 FRANKLIN VILLAGE DR
Mailing Address - Street 2:SUITE 212
Mailing Address - City:FRANKLIN
Mailing Address - State:MA
Mailing Address - Zip Code:02038-4017
Mailing Address - Country:US
Mailing Address - Phone:508-613-6380
Mailing Address - Fax:
Practice Address - Street 1:500 FRANKLIN VILLAGE DR
Practice Address - Street 2:SUITE 212
Practice Address - City:FRANKLIN
Practice Address - State:MA
Practice Address - Zip Code:02038-4017
Practice Address - Country:US
Practice Address - Phone:508-613-6380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-14
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty