Provider Demographics
NPI:1952836546
Name:VENDETTI WELLNESS GROUP, PC
Entity Type:Organization
Organization Name:VENDETTI WELLNESS GROUP, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:VENDETTI
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:774-412-3306
Mailing Address - Street 1:77 MAIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:HOPKINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01748-1193
Mailing Address - Country:US
Mailing Address - Phone:774-509-5059
Mailing Address - Fax:774-250-2693
Practice Address - Street 1:1 CLARKS HL STE 302
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-8172
Practice Address - Country:US
Practice Address - Phone:508-589-5333
Practice Address - Fax:774-250-2693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-21
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA114012251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health