Healthcare Provider Details

I. General information

NPI: 1629998208
Provider Name (Legal Business Name): MINDNBEYOND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

859 WASHINGTON ST STE 4E
SOUTH EASTON MA
02375-1943
US

IV. Provider business mailing address

859 WASHINGTON ST STE 4E
SOUTH EASTON MA
02375-1943
US

V. Phone/Fax

Practice location:
  • Phone: 617-221-5007
  • Fax: 800-975-1804
Mailing address:
  • Phone: 617-221-5007
  • Fax: 800-975-1804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CYNTHIA C IWUNZE
Title or Position: PMHNP
Credential:
Phone: 617-221-5007