NPIMap

Organization Active NPI

Triwellness Holistic Center LLC

  • Clinical Social Worker
  • South Boston, MA
National Provider Identifier
1760993554
Registry record updated Oct 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
115897 Issued in MA
Legal business name
TRIWELLNESS HOLISTIC CENTER LLC
Practice address
14 Dorchester St Ste 2
South Boston, MA 02127-1306
Phone
(508) 617-0070
NPI assigned
Oct 19, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2017

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

Authorized official

Name
Ms. Carol A Soldevilla, LICSWNPI 1104191501
Title
Partner
Phone
(508) 610-0070

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: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 115897 MA Primary

Addresses

Primary practice location

14 Dorchester St Ste 2
South Boston, MA 02127-1306

Mailing address

14 Dorchester St Ste 2
South Boston, MA 02127-1306
Phone (508) 617-0070

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": "1508371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508371200000",
    "number": "1760993554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 DORCHESTER ST STE 2",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021271306",
            "telephone_number": "508-617-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 DORCHESTER ST STE 2",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021271306",
            "telephone_number": "508-617-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIWELLNESS HOLISTIC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-19",
        "last_updated": "2017-10-19",
        "status": "A",
        "authorized_official_last_name": "SOLDEVILLA",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "508-610-0070",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "115897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2017; 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.