Healthcare Provider Details

I. General information

NPI: 1962311571
Provider Name (Legal Business Name): UNEARTH WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 W GROVE ST STE A
MIDDLEBORO MA
02346-1462
US

IV. Provider business mailing address

205 W GROVE ST STE A
MIDDLEBORO MA
02346-1462
US

V. Phone/Fax

Practice location:
  • Phone: 774-206-6635
  • Fax: 774-228-4441
Mailing address:
  • Phone: 774-206-6635
  • Fax: 774-228-4441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. TRACEY KELCE
Title or Position: FOUNDER/OWNER
Credential: LMHC
Phone: 774-206-6635