Healthcare Provider Details

I. General information

NPI: 1023701596
Provider Name (Legal Business Name): MATERNAL WELLNESS GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2023
Last Update Date: 05/31/2023
Certification Date: 05/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

76 S MAIN ST
COHASSET MA
02025-2061
US

IV. Provider business mailing address

58 BAY RD
DUXBURY MA
02332-5018
US

V. Phone/Fax

Practice location:
  • Phone: 617-807-0410
  • Fax:
Mailing address:
  • Phone: 978-302-9737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. LAURA K ROBINSON
Title or Position: DIRECTOR, PSYCHOLOGIST
Credential: PSY.D.
Phone: 978-302-9737