NPIMap

Organization Active NPI

Well Kneaded Therapeutic Massage, LLC.

  • Massage Therapist
  • Peabody, MA
National Provider Identifier
1184937773
Registry record updated Jul 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
5891 Issued in MA
Legal business name
WELL KNEADED THERAPEUTIC MASSAGE, LLC.
Practice address
15 Chestnut St
Peabody, MA 01960-5429
Phone
(978) 473-1837
NPI assigned
Jul 23, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2010

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

Authorized official

Name
Sracey E Lubas
Title
Owner
Phone
(978) 473-1837

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X 5891 MA Primary

Addresses

Primary practice location

15 Chestnut St
Peabody, MA 01960-5429

Mailing address

12 Connor Rd
Beverly, MA 01915-1310

National Provider Directory

National Provider Directory

Locations

15 Chestnut St
Peabody, MA 01960
Phone (781) 718-1151

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1279843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279843200000",
    "number": "1184937773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 CONNOR RD",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CHESTNUT ST",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019605429",
            "telephone_number": "978-473-1837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELL KNEADED THERAPEUTIC MASSAGE, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-23",
        "last_updated": "2010-07-23",
        "status": "A",
        "authorized_official_last_name": "LUBAS",
        "authorized_official_first_name": "SRACEY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "978-473-1837"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "MA",
            "license": "5891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2010; 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.