Healthcare Provider Details

I. General information

NPI: 1396651188
Provider Name (Legal Business Name): A WELL OF HEALTH MEDICAL & BEHAVIORAL CARE CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 BELMONT ST
BROCKTON MA
02301-5289
US

IV. Provider business mailing address

37 BELMONT ST
BROCKTON MA
02301-5289
US

V. Phone/Fax

Practice location:
  • Phone: 617-212-0711
  • Fax: 617-212-0711
Mailing address:
  • Phone:
  • 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: MRS. MARIE-RENEE DARLINE LUCIEN-JEAN LUCIEN-JEAN
Title or Position: NURSE PRACTITIONER
Credential: LUCIEN-JEAN
Phone: 617-212-0711