Healthcare Provider Details

I. General information

NPI: 1821992330
Provider Name (Legal Business Name): SUMMIT FAMILY BEHAVIORAL SOLUTIONS, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 EUSTIS AVE
WAKEFIELD MA
01880
US

IV. Provider business mailing address

71 EUSTIS AVE
WAKEFIELD MA
01880
US

V. Phone/Fax

Practice location:
  • Phone: 978-701-7909
  • Fax:
Mailing address:
  • Phone: 978-701-7909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. BETHANY WALSH NELSON
Title or Position: OWNER/MANAGING MEMBER
Credential: M.ED., BCBA, LABA
Phone: 978-701-7909