Carol Gavin, PMHNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Maynard, MA
NPI 1003289729 · NPPES record last updated Dec 31, 2024
Key facts
- NPI
- 1003289729
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 0024173036 (VA)
- Practice address
- Telemynd
141 Parker St Suite 306
Maynard, MA 01754 - Phone
- (866) 991-2163
- NPI assigned
- Nov 3, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 0024173036 | VA | Yes |
Addresses
Primary practice location
Telemynd
141 Parker St Suite 306
Maynard, MA 01754
Mailing address
Telemynd
141 Parker St Suite 306
Maynard, MA 01754
Phone (866) 991-2163
Other practice location 1
19 Fort Evans Rd NE Ste C
Leesburg, VA 20176-4487
Phone (703) 737-2110
Other providers in Maynard, MA
- Emma R Epstein
- Extra Steps Pediatric Therapies, Inc.
- Jennifer Freidel
- Megan Gatsogiannis
- Jill Lynn Gaudet
- Melanie Ann Glassey
- Anca Goller
- Elizabeth Gudmand
- Randa Hadayia
- Erina M Hammer
All providers in Maynard, MA · Psychiatric/Mental Health Nurse Practitioner in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 31, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.