Healthcare Provider Details

I. General information

NPI: 1881592863
Provider Name (Legal Business Name): INTEGRATIVE MIND & WELLNESS PARTNERS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2026
Last Update Date: 10/28/2026
Certification Date: 10/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 CUMMINGS CTR STE 6500
BEVERLY MA
01915-6234
US

IV. Provider business mailing address

500 CUMMINGS CTR STE 6500
BEVERLY MA
01915-6234
US

V. Phone/Fax

Practice location:
  • Phone: 978-949-1201
  • Fax:
Mailing address:
  • Phone: 978-949-1201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: HUONG NGUYEN MADRIGAL
Title or Position: SOLE MEMBER/OWNER
Credential: DNP, APRN, PMHNP
Phone: 978-949-1201