Healthcare Provider Details

I. General information

NPI: 1114803491
Provider Name (Legal Business Name): ASCEND PSYCHIATRY AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2025
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 PUDDING BROOK DR
PEMBROKE MA
02359-2008
US

IV. Provider business mailing address

75 PUDDING BROOK DR
PEMBROKE MA
02359-2008
US

V. Phone/Fax

Practice location:
  • Phone: 240-462-0420
  • Fax:
Mailing address:
  • Phone: 240-462-0420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: MS. JOANNE ST JOHN
Title or Position: PRACTICE OWNER/MANAGER
Credential: CEO
Phone: 240-462-0420