Healthcare Provider Details

I. General information

NPI: 1447061189
Provider Name (Legal Business Name): MINDMATTERS WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2025
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

287 GROVE ST STE 260
WORCESTER MA
01605-3905
US

IV. Provider business mailing address

585 ARMISTICE BLVD
PAWTUCKET RI
02861-2648
US

V. Phone/Fax

Practice location:
  • Phone: 774-253-0104
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1000X
TaxonomyMigrant Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MARGARET FREMPONG
Title or Position: CEO
Credential:
Phone: 774-253-0104