The Wellness Room

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

114084 Issued in MA

Legal business name

THE WELLNESS ROOM

Practice address

288 Walnut St Ste 220
Newton, MA 02460-1994

Phone

(617) 775-5373

NPI assigned

Jun 29, 2012

Organization subpart

No

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

Authorized official

Name

Haven Fyfe-Kiernan, LICSWNPI 1881883544

Title

Owner and Operator

Phone

(617) 775-5373

Specialties & licenses 1

Addresses

Practitioners 2

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

• Haven Fyfe-Kiernan, MSW, LICSW

  • Clinical Social Worker
  • Brookline, MA
  • NPI 1881883544
  NPD (past) Authorized official
• Samantha A Manewitz, LICSW, LCSW

  • Clinical Social Worker
  • Newton, MA
  • NPI 1073870481
  NPD (past)

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

{
    "created_epoch": "1340928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340928000000",
    "number": "1841554300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 COLUMBUS ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024611436",
            "telephone_number": "617-775-5373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "288 WALNUT ST STE 220",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024601994",
            "telephone_number": "617-775-5373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WELLNESS ROOM",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-29",
        "last_updated": "2012-06-29",
        "status": "A",
        "authorized_official_last_name": "FYFE-KIERNAN",
        "authorized_official_first_name": "HAVEN",
        "authorized_official_title_or_position": "OWNER AND OPERATOR",
        "authorized_official_telephone_number": "617-775-5373",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MA",
            "license": "114084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Academy of Physical and Social Development
• The Carroll Center for the Blind Inc.
• The Haven Collective
• The Smile Atelier PLLC
• The Spiegel Center
• Laura Theodor Shibles, PHD
• Hong-Thao Thieu, MD
• Hannah Thomas, OTR/L
• Kameron L Thomas
• Lori Thomas, MA

• Community/Behavioral Health Agency in Newton, MA
• Providers in Newton, MA by specialty
• Community/Behavioral Health Agency in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2012; 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.