Healthcare Provider Details

I. General information

NPI: 1437864949
Provider Name (Legal Business Name): FIERCE HEALING AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2023
Last Update Date: 01/18/2023
Certification Date: 01/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CUMMINGS CTR STE 323H
BEVERLY MA
01915-6119
US

IV. Provider business mailing address

100 CUMMINGS CTR STE 323H
BEVERLY MA
01915-6119
US

V. Phone/Fax

Practice location:
  • Phone: 978-225-0595
  • Fax: 978-226-4532
Mailing address:
  • Phone: 978-225-0595
  • Fax: 978-226-4532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: STACEY BILLINGTON
Title or Position: PSYCHOTHERAPIST/OWNER
Credential: LICSW
Phone: 978-225-0595