Organization Active NPI

Well of Wisdom Therapy, LLC

  • Clinical Social Worker
  • Boston, MA
National Provider Identifier
1417539776
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
WELL OF WISDOM THERAPY, LLC
Practice address
185 Devonshire St Ste 502
Boston, MA 02110-1407
Phone
(617) 221-7515
NPI assigned
Apr 26, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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

Authorized official

Name
Ms. Mariajose Cruz, LICSWNPI 1336651991
Title
Mental Health Clinician
Phone
(617) 221-7515

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

185 Devonshire St Ste 502
Boston, MA 02110-1407

Mailing address

185 Devonshire St Ste 502
Boston, MA 02110-1407
Phone (617) 221-7515

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL CONNECT

National Provider Directory

National Provider Directory

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": "1619395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619395200000",
    "number": "1417539776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 DEVONSHIRE ST STE 502",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021101407",
            "telephone_number": "617-221-7515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 DEVONSHIRE ST STE 502",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021101407",
            "telephone_number": "617-221-7515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELL OF WISDOM THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-26",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A",
        "authorized_official_last_name": "CRUZ",
        "authorized_official_first_name": "MARIAJOSE",
        "authorized_official_title_or_position": "MENTAL HEALTH CLINICIAN",
        "authorized_official_telephone_number": "617-221-7515",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "CONNECT",
            "affiliation": "N",
            "address_1": "185 Devonshire St Ste 502",
            "city": "Boston",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021101407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; 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.