Healthcare Provider Details

I. General information

NPI: 1306382833
Provider Name (Legal Business Name): SYNERGY SOLUTIONS TODAY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2017
Last Update Date: 01/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 TRESCOTT ST
TAUNTON MA
02780-3265
US

IV. Provider business mailing address

23 TRESCOTT ST
TAUNTON MA
02780-3265
US

V. Phone/Fax

Practice location:
  • Phone: 508-821-0607
  • Fax:
Mailing address:
  • Phone: 508-821-0607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number119390
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN215314
License Number StateMA

VIII. Authorized Official

Name: CHRISTINE BOWDEN
Title or Position: OWNER
Credential: LICSW
Phone: 508-821-0607