Provider Demographics
NPI:1134535610
Name:MARIGOLD THERAPY & WELLNESS
Entity type:Organization
Organization Name:MARIGOLD THERAPY & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDING PARTNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:QUINCY
Authorized Official - Middle Name:
Authorized Official - Last Name:LASHLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:978-712-9186
Mailing Address - Street 1:130 CENTRE ST
Mailing Address - Street 2:HOWE BARN #105
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-1400
Mailing Address - Country:US
Mailing Address - Phone:978-712-9186
Mailing Address - Fax:
Practice Address - Street 1:130 CENTRE ST
Practice Address - Street 2:HOWE BARN #105
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-1400
Practice Address - Country:US
Practice Address - Phone:978-712-9186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-07
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8802101YM0800X
MA1477106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty