Healthcare Provider Details

I. General information

NPI: 1245163351
Provider Name (Legal Business Name): VERTIVEA HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 OAK ST
BROCKTON MA
02305-0501
US

IV. Provider business mailing address

200 OAK ST
BROCKTON MA
02305-0501
US

V. Phone/Fax

Practice location:
  • Phone: 508-840-0707
  • Fax:
Mailing address:
  • Phone: 617-279-5427
  • Fax: 857-232-6448

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: SHAPPA LORQUET
Title or Position: MANAGING MEMBER
Credential: PMHNP-BC
Phone: 508-840-0707