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General NPI Number Information
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NPI Number | 1770438624
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Entity Type | Organization
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Legal Business Name | THE CHILD AND FAMILY WELLNESS CENTER
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Dates
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Enumeration Date | 03/04/2026
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Last Update Date | 03/04/2026
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Provider Practice Location Address
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Address Line | 1234 HYDE PARK AVE
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City | HYDE PARK
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State | MA
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Zip | 02136-2819
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Country | US
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Telephone | 888-763-7272
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Fax | 877-243-2959
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Provider Business Mailing Address
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Address Line | 1234 HYDE PARK AVE
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City | HYDE PARK
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State | MA
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Zip | 02136-2819
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Country | US
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Telephone | 888-763-7272
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Fax | 877-243-2959
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Authorized Official
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Title or Position | COUNSELOR
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Name | MR. MATTHEW ALEXANDER LEZAMA
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Credential | MA
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Telephone | 617-855-5618
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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