Healthcare Provider Details

I. General information

NPI: 1205772530
Provider Name (Legal Business Name): CARIDAD BEHAVIORAL HEALTH & COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S MAIN ST
RANDOLPH MA
02368-4896
US

IV. Provider business mailing address

101 S MAIN ST
RANDOLPH MA
02368-4896
US

V. Phone/Fax

Practice location:
  • Phone: 781-885-1618
  • Fax: 781-885-7866
Mailing address:
  • Phone: 781-885-1618
  • Fax: 781-885-7866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MARVEL LAROSE
Title or Position: OWNER/ADMINISTRATOR
Credential: PMHNP-BC
Phone: 857-991-0110