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General NPI Number Information
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NPI Number | 1346099660
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Entity Type | Organization
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Legal Business Name | BENCHMARK PSYCHOTHERAPY & MEDICATION MANAGEMENT, LLC
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Dates
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Enumeration Date | 05/17/2024
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Last Update Date | 05/17/2024
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Provider Practice Location Address
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Address Line | 470 WASHINGTON STREET SUITE 22
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City | NORWOOD
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State | MA
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Zip | 02062
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Country | US
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Telephone | 617-835-9510
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Fax | 617-687-7740
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Provider Business Mailing Address
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Address Line | 22 HAVILEND STREET
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City | WOLLASTON
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State | MA
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Zip | 02170-3511
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Country | US
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Telephone | 617-835-9510
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Fax | 617-687-7740
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Authorized Official
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Title or Position | OWNER
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Name | MS. ROSEANNE C DOLAN
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Credential | APRN-BC
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Telephone | 617-835-9510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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