NPIMap

Organization Active NPI

Northeast Wellness, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Arlington, MA
National Provider Identifier
1215528641
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
NORTHEAST WELLNESS, LLC
Practice address
22 Mill St Ste 108
Arlington, MA 02476-4738
Phone
(617) 848-4417
Fax
(617) 848-4417
NPI assigned
Jan 28, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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

Authorized official

Name
Amandeep Kaur
Title
Chief Administration Officer
Phone
(781) 469-5320

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

22 Mill St Ste 108
Arlington, MA 02476-4738

Mailing address

71 Commercial St # 166
Boston, MA 02109-1320
Phone (617) 848-4417

National Provider Directory

National Provider Directory

Locations

71 Commercial St
Boston, MA 02109
Phone (617) 548-1670

400 W Cummings Park
Ste 2050
Woburn, MA 01801

Practitioners & affiliated clinicians

Practitioners 7

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": "1611792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646697600000",
    "number": "1215528641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 COMMERCIAL ST # 166",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021091320",
            "telephone_number": "617-848-4417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 MILL ST STE 108",
            "city": "ARLINGTON",
            "state": "MA",
            "postal_code": "024764738",
            "telephone_number": "617-848-4417",
            "fax_number": "617-848-4417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-28",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-02",
        "status": "A",
        "authorized_official_last_name": "KAUR",
        "authorized_official_first_name": "AMANDEEP",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATION OFFICER",
        "authorized_official_telephone_number": "781-469-5320"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; 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.