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General NPI Number Information
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NPI Number | 1700565397
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Entity Type | Organization
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Legal Business Name | MOSAIC MENTAL HEALTH, LLC
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Dates
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Enumeration Date | 07/12/2023
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Last Update Date | 08/13/2024
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Provider Practice Location Address
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Address Line | 167 WASHINGTON ST STE 36
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City | NORWELL
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State | MA
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Zip | 02061-1797
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Country | US
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Telephone | 781-757-4784
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Fax |
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Provider Business Mailing Address
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Address Line | 377 WILLARD ST # 317
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City | QUINCY
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State | MA
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Zip | 02169-6122
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Country | US
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Telephone | 781-757-4784
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | JENNA MARKLAND
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Credential | LMHC
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Telephone | 781-757-4784
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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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