Healthcare Provider Details

I. General information

NPI: 1477672285
Provider Name (Legal Business Name): ATRIUS HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 06/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 CAMBRIDGE ST
CAMBRIDGE MA
02138-4302
US

IV. Provider business mailing address

275 GROVE ST SUITE 3-300
AUBURNDALE MA
02466-2272
US

V. Phone/Fax

Practice location:
  • Phone: 617-661-5500
  • Fax:
Mailing address:
  • Phone: 617-559-8374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. DANEIL BURNES
Title or Position: INTERIM CHIEF EXECUTIVE OFFICER
Credential:
Phone: 617-559-8393