Organization Active NPI

Harbor Wellness, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Carver, MA
National Provider Identifier
1861204745
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
HARBOR WELLNESS, PLLC
Practice address
5 Richfield Circle
Carver, MA 02330
Phone
(508) 422-0404
Fax
(508) 422-0404
NPI assigned
Jan 27, 2025
Last updated
Jan 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Authorized official

Name
Wayne Ethier, MSNNPI 1992095798
Title
Owner/Authorized Offical
Phone
(508) 422-0404

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 Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

5 Richfield Circle
Carver, MA 02330

Mailing address

6 Liberty SQ Ste 91536
Boston, MA 02109-5800
Phone (508) 422-0404

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1737936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1861204745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 LIBERTY SQ STE 91536",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021095800",
            "telephone_number": "508-422-0404",
            "fax_number": "508-422-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 RICHFIELD CIRCLE",
            "city": "CARVER",
            "state": "MA",
            "postal_code": "02330",
            "telephone_number": "508-422-0404",
            "fax_number": "508-422-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-27",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-17",
        "status": "A",
        "authorized_official_last_name": "ETHIER",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER/AUTHORIZED OFFICAL",
        "authorized_official_telephone_number": "508-422-0404",
        "authorized_official_credential": "MSN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carver, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; 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.