Massachusetts Center for Adolescent Wellness, LLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

MASSACHUSETTS CENTER FOR ADOLESCENT WELLNESS, LLC

Practice address

639 Granite St Ste 402
Braintree, MA 02184-5369

Phone

(603) 703-2545

NPI assigned

Oct 3, 2023

Organization subpart

No

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

Authorized official

Name

Edward Thatcher

Title

Cfo

Phone

(754) 217-8127

Specialties & licenses 2

Addresses

Tax ID family

Massachusetts Center for Adolescent Wellness LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Massachusetts Center for Adolescent Wellness, LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Lynnfield, MA
  • NPI 1164129177
  NPD tax ID

Locations

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

{
    "created_epoch": "1696291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696291200000",
    "number": "1851171219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 GRANITE ST STE 402",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021845369",
            "telephone_number": "603-703-2545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 GRANITE ST STE 402",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021845369",
            "telephone_number": "603-703-2545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASSACHUSETTS CENTER FOR ADOLESCENT WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-03",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A",
        "authorized_official_last_name": "THATCHER",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "754-217-8127"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haley Erin Martel, RBT
• Martin E Geher DMD
• Mass General Brigham Ambulatory Surgery Weymouth, LLC
• Mass Kidz Healthy Smiles LLC
• Mass Optometric Associates, PLLC
• Victoria Ann Mathieu
• Anjali Mathur, M.S.P.T
• Alexi R Matta
• Jessica Matzkin, LICSW
• Lucia Mayers

• Adolescent and Children Mental Health Clinic/Center in Braintree, MA
• Providers in Braintree, MA by specialty
• Adolescent and Children Mental Health Clinic/Center in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; 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.