Healthcare Provider Details

I. General information

NPI: 1194228403
Provider Name (Legal Business Name): PAUSE WELLNESS CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2018
Last Update Date: 08/16/2022
Certification Date: 08/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 MAIN STREET BUILDING 2, SUITE F
NORTHBOROUGH MA
01532
US

IV. Provider business mailing address

130 MAIN STREET BUILDING 2, SUITE F
NORTHBOROUGH MA
01532
US

V. Phone/Fax

Practice location:
  • Phone: 508-393-2731
  • Fax:
Mailing address:
  • Phone: 508-393-2731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: SARAH HAMELIN
Title or Position: OWNER
Credential: LICSW
Phone: 508-393-2731