Provider Demographics
NPI:1952054546
Name:ONYX COUNSELING AND WELLNESS LLC
Entity Type:Organization
Organization Name:ONYX COUNSELING AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MANCHESTER-MILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-249-3577
Mailing Address - Street 1:11 APEX DR STE 300A
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-1977
Mailing Address - Country:US
Mailing Address - Phone:617-249-3577
Mailing Address - Fax:617-812-1702
Practice Address - Street 1:11 APEX DR STE 300A
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-1977
Practice Address - Country:US
Practice Address - Phone:617-249-3577
Practice Address - Fax:617-812-1702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-02
Last Update Date:2022-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health