Healthcare Provider Details

I. General information

NPI: 1124965678
Provider Name (Legal Business Name): INTEGRATIVE SOUL AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CENTRAL ST STE 203
MIDDLETON MA
01949-1700
US

IV. Provider business mailing address

1 CENTRAL ST STE 203
MIDDLETON MA
01949-1700
US

V. Phone/Fax

Practice location:
  • Phone: 781-435-6338
  • Fax:
Mailing address:
  • Phone: 781-435-6338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: KRISTEN PRATT
Title or Position: MANAGING MEMBER
Credential: LMHC
Phone: 781-435-6338