Healthcare Provider Details

I. General information

NPI: 1710571997
Provider Name (Legal Business Name): CULTIVATE CALM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2021
Last Update Date: 09/29/2021
Certification Date: 09/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

796 BEACON ST
NEWTON MA
02459-1935
US

IV. Provider business mailing address

87 WHITE ST
BOSTON MA
02128-1340
US

V. Phone/Fax

Practice location:
  • Phone: 603-320-6210
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: CORI PURCELL
Title or Position: LICSW/OWNER
Credential:
Phone: 603-320-6210