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General NPI Number Information
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NPI Number | 1124623806
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Entity Type | Organization
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Legal Business Name | MODERN PSYCHIATRIC SERVICES LLC
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Dates
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Enumeration Date | 12/01/2020
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 8 GROVE ST STE 400A
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City | WELLESLEY
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State | MA
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Zip | 02482-7726
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Country | US
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Telephone | 617-546-6700
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Fax | 617-546-6800
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Provider Business Mailing Address
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Address Line | 8 GROVE ST STE 400A
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City | WELLESLEY
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State | MA
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Zip | 02482-7726
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Country | US
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Telephone | 617-546-6700
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Fax | 617-546-6800
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Authorized Official
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Title or Position | OWNER & PSYCH NP
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Name | LEAH BELLMAN MILLER
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Credential | MSN, RN, PMHNP-BC
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Telephone | 617-546-6700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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