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General NPI Number Information
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NPI Number | 1699592709
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Entity Type | Organization
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Legal Business Name | TEND MENTAL WELLNESS
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Dates
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Enumeration Date | 09/21/2024
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Last Update Date | 12/21/2024
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Provider Practice Location Address
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Address Line | 1 MARINA PARK DR
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City | BOSTON
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State | MA
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Zip | 02210-1832
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Country | US
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Telephone | 617-388-2055
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Fax |
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Provider Business Mailing Address
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Address Line | 593 E BROADWAY APT 3
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City | BOSTON
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State | MA
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Zip | 02127-4493
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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 | MENTAL HEALTH THERAPIST/FOUNDER
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Name | NIKKIA MARCIN
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Credential | LMHC
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Telephone | 617-388-2055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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