Healthcare Provider Details

I. General information

NPI: 1134571201
Provider Name (Legal Business Name): LEAH BELLMAN MILLER PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2016
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 GROVE ST STE 400A
WELLESLEY MA
02482-7726
US

IV. Provider business mailing address

8 GROVE ST STE 400A
WELLESLEY MA
02482-7726
US

V. Phone/Fax

Practice location:
  • Phone: 617-546-6700
  • Fax: 617-546-6800
Mailing address:
  • Phone: 617-546-6700
  • Fax: 617-546-6800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2298749
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number836082
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2298749
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: