Massachusetts Center for Adolescent Wellness, LLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

MASSACHUSETTS CENTER FOR ADOLESCENT WELLNESS, LLC

Practice address

230 Broadway Ste 201
Lynnfield, MA 01940-2320

Phone

(781) 334-8781

NPI assigned

Feb 9, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ed Thatcher

Title

Chief Financial Officer

Phone

(754) 217-8127

Specialties & licenses 2

Addresses

Tax ID family

Massachusetts Center for Adolescent Wellness LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Massachusetts Center for Adolescent Wellness, LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Braintree, MA
  • NPI 1851171219
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lindsey Lauren Randall, PA-C

  • Physician Assistant
  • Lynnfield, MA
  • NPI 1679023931
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1675900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716854400000",
    "number": "1164129177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 BROADWAY STE 201",
            "city": "LYNNFIELD",
            "state": "MA",
            "postal_code": "019402320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 BROADWAY STE 201",
            "city": "LYNNFIELD",
            "state": "MA",
            "postal_code": "019402320",
            "telephone_number": "781-334-8781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASSACHUSETTS CENTER FOR ADOLESCENT WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-09",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A",
        "authorized_official_last_name": "THATCHER",
        "authorized_official_first_name": "ED",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "754-217-8127"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Maina
• Mallory Flynn
• Anna Marong, RN
• Martone Chiropractic & Wellness Center PC
• Peter D Martone, D.C.
• Leslie Mayo-Smith
• Jessica McDonald
• Leslie Ann McKeough, LICSW
• Caroline Mendes, R.D.
• Laurie Ann Merker, MD

• Adolescent and Children Mental Health Clinic/Center in Lynnfield, MA
• Providers in Lynnfield, MA by specialty
• Adolescent and Children Mental Health Clinic/Center in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.