Provider Demographics
NPI:1710449699
Name:WELLNESS IN MIND PSYCHOTHERAPY, PLLC
Entity Type:Organization
Organization Name:WELLNESS IN MIND PSYCHOTHERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCARDINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-982-8624
Mailing Address - Street 1:101 ARCH ST FL 8
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02110-7500
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 ARCH ST FL 8
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02110-7500
Practice Address - Country:US
Practice Address - Phone:617-982-8624
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-01
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1407126667OtherNPI