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General NPI Number Information
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NPI Number | 1528838737
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Entity Type | Organization
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Legal Business Name | GROUNDED INTERVENTIONS PSYCHIATRIC AND WELLNESS SERVICES
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Dates
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Enumeration Date | 01/08/2024
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Last Update Date | 01/08/2024
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Provider Practice Location Address
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Address Line | 104 CHARLES ELDRIDGE RD STE 6
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City | LAKEVILLE
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State | MA
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Zip | 02347-1388
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Country | US
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Telephone | 774-406-4777
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Fax | 508-644-3921
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Provider Business Mailing Address
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Address Line | 104 CHARLES ELDRIDGE RD STE 6
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City | LAKEVILLE
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State | MA
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Zip | 02347-1388
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Country | US
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Telephone | 774-406-4777
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Fax | 508-644-3921
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Authorized Official
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Title or Position | MEDICAL DIRECTOR/OWNER
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Name | MS. RENEE M GARBITT
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Credential | LMHC, C-NP, PMHNP-BC
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Telephone | 508-886-3921
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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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