Healthcare Provider Details

I. General information

NPI: 1760956700
Provider Name (Legal Business Name): FOUNDATION FOR LEARNING & INSPIRING HEALTH & HEALING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2019
Last Update Date: 01/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 FOREST ST
MARSHFIELD MA
02050-2335
US

IV. Provider business mailing address

421 FOREST ST
MARSHFIELD MA
02050-2335
US

V. Phone/Fax

Practice location:
  • Phone: 781-834-5750
  • Fax:
Mailing address:
  • Phone: 781-834-5750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name: SHERI L DAMON
Title or Position: OWNER/PRESIDENT
Credential: LMHC
Phone: 781-834-5750