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General NPI Number Information
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NPI Number | 1174474365
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Entity Type | Organization
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Legal Business Name | GROWING LIGHT PSYCHIATRY AND WELLNESS, PLLC
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Dates
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Enumeration Date | 02/04/2026
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 1660 SOLDIERS FIELD RD STE 7-1030
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City | BRIGHTON
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State | MA
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Zip | 02135-1108
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Country | US
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Telephone | 617-924-6484
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Fax |
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Provider Business Mailing Address
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Address Line | 1660 SOLDIERS FIELD RD STE 7-1030
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City | BRIGHTON
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State | MA
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Zip | 02135-1108
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PMHMP/FOUNDER CEO
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Name | JENNIFER OUNG MATHURIN
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Credential | FNP, PMHNP
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Telephone | 774-240-0545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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