Organization Active NPI

Emmanuel Integrative Psychiatry & Wellness

  • Psychiatric/Mental Health Nurse Practitioner
  • Randolph, MA
National Provider Identifier
1528811445
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
EMMANUEL INTEGRATIVE PSYCHIATRY & WELLNESS
Practice address
4 Frank Leary Way Ste 1
Randolph, MA 02368-4512
Phone
(855) 405-9355
NPI assigned
Apr 10, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Authorized official

Name
Nadia Valentin, NPNPI 1558420182
Title
Clinical Director
Phone
(855) 405-9355

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
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

4 Frank Leary Way Ste 1
Randolph, MA 02368-4512

Mailing address

4 Frank Leary Way Ste 1
Randolph, MA 02368-4512
Phone (855) 405-9355

National Provider Directory

National Provider Directory

Locations

4 Frank Leary Way
Ste 1
Randolph, MA 02368
Phone (855) 405-9355

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": "1712707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712707200000",
    "number": "1528811445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 FRANK LEARY WAY STE 1",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023684512",
            "telephone_number": "855-405-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 FRANK LEARY WAY STE 1",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023684512",
            "telephone_number": "855-405-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMMANUEL INTEGRATIVE PSYCHIATRY & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-10",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A",
        "authorized_official_last_name": "VALENTIN",
        "authorized_official_first_name": "NADIA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "855-405-9355",
        "authorized_official_credential": "NP"
    },
    "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 Randolph, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.