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General NPI Number Information
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NPI Number | 1265373278
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Entity Type | Organization
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Legal Business Name | FOUNDATIONS COUNSELING AND WELLNESS, LLC
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Dates
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Enumeration Date | 04/03/2026
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Last Update Date | 04/03/2026
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Provider Practice Location Address
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Address Line | 14 DALLAS ST
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City | WORCESTER
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State | MA
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Zip | 01604-1216
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Country | US
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Telephone | 508-342-5029
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Fax | 855-485-5375
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Provider Business Mailing Address
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Address Line | 14 DALLAS ST
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City | WORCESTER
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State | MA
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Zip | 01604-1216
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Country | US
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Telephone | 508-342-5029
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Fax | 855-485-5375
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Authorized Official
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Title or Position | OWNER
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Name | MELISSA AYANTOLA
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Credential | LMHC
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Telephone | 603-499-5787
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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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