Provider Demographics
NPI:1669114229
Name:MARBLEHEAD FAMILY THERAPY AND WELLNESS CORPORATION
Entity type:Organization
Organization Name:MARBLEHEAD FAMILY THERAPY AND WELLNESS CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:SLAVET
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:413-222-0432
Mailing Address - Street 1:55 KENNETH RD
Mailing Address - Street 2:
Mailing Address - City:MARBLEHEAD
Mailing Address - State:MA
Mailing Address - Zip Code:01945-1541
Mailing Address - Country:US
Mailing Address - Phone:413-222-0432
Mailing Address - Fax:
Practice Address - Street 1:16 ANDERSON ST STE 208
Practice Address - Street 2:
Practice Address - City:MARBLEHEAD
Practice Address - State:MA
Practice Address - Zip Code:01945-2488
Practice Address - Country:US
Practice Address - Phone:781-277-2470
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)