Healthcare Provider Details

I. General information

NPI: 1174715957
Provider Name (Legal Business Name): CYLLENE ARICE SAINTELIEN PMHNP-BC, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CYLLENE HOLMES PMHNP

II. Dates (important events)

Enumeration Date: 08/15/2007
Last Update Date: 08/30/2024
Certification Date: 08/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 LONG POND RD STE 11B
PLYMOUTH MA
02360-2785
US

IV. Provider business mailing address

124 LONG POND RD STE 11B
PLYMOUTH MA
02360-2785
US

V. Phone/Fax

Practice location:
  • Phone: 617-202-3003
  • Fax: 617-326-2637
Mailing address:
  • Phone: 617-202-3003
  • Fax: 617-326-2637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number281148
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2009011171
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: