Healthcare Provider Details

I. General information

NPI: 1811771918
Provider Name (Legal Business Name): HOLISTIC WELL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2023
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 W CENTRAL ST
NATICK MA
01760-3765
US

IV. Provider business mailing address

32 MORELAND ST
WORCESTER MA
01609-1023
US

V. Phone/Fax

Practice location:
  • Phone: 781-384-1327
  • Fax:
Mailing address:
  • Phone: 781-384-1327
  • Fax: 781-205-1564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CECILY ROSS
Title or Position: PRRESIDENT
Credential: PMHNP
Phone: 781-384-1327