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General NPI Number Information
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NPI Number | 1679363097
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Entity Type | Organization
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Legal Business Name | CK WELLNESS PLLC
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Dates
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Enumeration Date | 05/08/2025
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 529 PEARL STREET
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City | BROCKTON
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State | MA
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Zip | 02301
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Country | US
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Telephone | 339-793-9080
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Fax |
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Provider Business Mailing Address
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Address Line | 729 BRIDGE ST STE 1 PMB 1046
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City | WEYMOUTH
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State | MA
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Zip | 02191-2135
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Country | US
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Telephone | 339-793-9080
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHIRNETT KHORRAN GAJARAJ
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Credential | NP-PMH
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Telephone | 339-793-9080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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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 | 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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