Healthcare Provider Details
I. General information
NPI: 1851430052
Provider Name (Legal Business Name): ATRIUS HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/05/2007
Last Update Date: 06/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
26 CITY HALL MALL
MEDFORD MA
02155-4754
US
IV. Provider business mailing address
275 GROVE ST SUITE 3-300
AUBURNDALE MA
02466-2272
US
V. Phone/Fax
- Phone: 781-306-5100
- Fax:
- Phone: 617-559-8374
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 364S00000X |
| Taxonomy | Clinical Nurse Specialist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DANIEL
BURNES
Title or Position: INTERIM CHIEF EXECUTIVE OFFICER
Credential:
Phone: 617-559-8393