Provider Demographics
NPI:1902613367
Name:PRESENT MOMENT, LLC
Entity type:Organization
Organization Name:PRESENT MOMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GHENA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIBEIRO
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LADC1, MAPGS
Authorized Official - Phone:315-439-2429
Mailing Address - Street 1:15 LINCOLN STREET
Mailing Address - Street 2:PMB 326
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14 TRAVERSE ST
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880
Practice Address - Country:US
Practice Address - Phone:315-439-2429
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty