Tranquil Mind & Wellness, Inc
Organization Active NPI Mental Health Counselor · Lakeville, MA
NPI 1376754267 · NPPES record last updated Oct 10, 2023
Key facts
- NPI
- 1376754267
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Legal business name
- TRANQUIL MIND & WELLNESS, INC
- Practice address
- 6 Alberta LN
Lakeville, MA 02347-1864 - Phone
- (508) 273-3726
- NPI assigned
- May 24, 2007
- Organization subpart
- No
Authorized official
- Name
- Ginny Kelly, LICSW
- Title
- Account Manager
- Phone
- (508) 947-1683
Practitioners 7
-
Ginny Lynn Kelly, LICSW
-
Debra Ann Bulger, LICSW
-
Elaine Marie Fillion-Crouse, L.I.C.S.W.
-
Lisa M Freitas, LICSW
-
Cameron Luree Marzelli, PH.D
-
Thomas J. Tanguay, LICSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080317000300 | MA | Part B Supplier - Clinic/Group Practice | 9032191978 |
Receives reassigned benefits from 2 practitioners Practice locations: Lakeville, MA |
National Provider Directory
Locations
109 Rhode Island Rd
Ste B
Lakeville, MA 02347
Phone (508) 947-1683
47 E Grove St
Middleboro, MA 02346
Phone (508) 927-1955
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | Yes |
Addresses
Primary practice location
6 Alberta LN
Lakeville, MA 02347-1864
Mailing address
6 Alberta LN
Lakeville, MA 02347-1864
Phone (508) 273-3726
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P30156 | Medicaid | MA | |
| 349493 | Other | MA | MAGELLAN BEHAVIORAL |
| P10263 | Other | MA | BCBS OF MASS |
Other providers in Lakeville, MA
- Jacqueline Ann Tolosko
- Total Approach Therapy, PC
- Town of Lakeville
- Town of Lakeville
- Jenna Duc Tran
- Travelling Dental Care, LLC
- Jacquelyn Tremblett
- True North Psychiatry Inc
- Lauren Louise Urbani
- Wagner PT & Performance LLC
All providers in Lakeville, MA · Mental Health Counselor in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.