Healthcare Provider Details

I. General information

NPI: 1699689885
Provider Name (Legal Business Name): SUSTAINABLE WELLNESS PSYCHIATRY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

149 COMMON ST
QUINCY MA
02169-1643
US

IV. Provider business mailing address

149 COMMON ST
QUINCY MA
02169-1643
US

V. Phone/Fax

Practice location:
  • Phone: 617-680-7706
  • Fax:
Mailing address:
  • Phone: 617-680-7706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. VALERIE C. DOHERTY-STUART
Title or Position: OWNER/OPERATOR
Credential: PMHNP-BC
Phone: 617-680-7706