Dove Emotional Wellness Center

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

DOVE EMOTIONAL WELLNESS CENTER

Practice address

40 Eastern Ave Ste 202
Malden, MA 02148-5030

Phone

(781) 330-2926

Fax

(671) 977-8665

NPI assigned

Aug 23, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Emile Lyns Hercule, LICSW

Title

Clinician

Phone

(781) 330-2926

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lyns Widdy Hercule, B.A

  • Social Worker
  • Roslindale, MA
  • NPI 1962633735
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664150400000",
    "number": "1790404994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 EASTERN AVE STE 202",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021485030",
            "telephone_number": "781-330-2926",
            "fax_number": "671-977-8665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 EASTERN AVE STE 202",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021485030",
            "telephone_number": "781-330-2926",
            "fax_number": "671-977-8665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOVE EMOTIONAL WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A",
        "authorized_official_last_name": "HERCULE",
        "authorized_official_first_name": "EMILE",
        "authorized_official_middle_name": "LYNS",
        "authorized_official_title_or_position": "CLINICIAN",
        "authorized_official_telephone_number": "781-330-2926",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Doolittle, MSW
• Choupette Doralus, LPN
• Sammantha Kathleen Dorazio
• Judith Dorismond
• Kamise Douglas
• Dr Clinical Resources
• Dr Mary P. Medwar PC
• Dr. Deborah Wayne
• Dr. Patricia Wu, DMD, PC
• David Dreissen

• Mental Health Counselor in Malden, MA
• Providers in Malden, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.