Provider Demographics
NPI:1982949871
Name:CAPE ANN CENTER FOR MINDFULNESS
Entity Type:Organization
Organization Name:CAPE ANN CENTER FOR MINDFULNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:BRESNAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:978-515-7648
Mailing Address - Street 1:1091 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01930-1129
Mailing Address - Country:US
Mailing Address - Phone:978-515-7648
Mailing Address - Fax:978-515-7684
Practice Address - Street 1:1091 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:MA
Practice Address - Zip Code:01930-1129
Practice Address - Country:US
Practice Address - Phone:978-515-7648
Practice Address - Fax:978-515-7684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-03
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9347103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty