MEDICARE: MARY CULLITON CNM, PMHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1407711245
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARY CULLITON CNM, PMHNP

Provider Business Mailing Address
First Line	:	337 WASHINGTON ST UNIT 81013
Second Line	:
City	:	WELLESLEY HILLS
State	:	MA
Zip	:	02481-8101
Country	:	US
Telephone Number	:	617-915-5268
Fax Number	:

Provider Business Practice Location Address
First Line	:	53 PROSPECT ST
Second Line	:
City	:	WELLESLEY HILLS
State	:	MA
Zip	:	02481-3308
Country	:	US
Telephone Number	:	617-915-5268
Fax Number	:

Authorized Official
Title or Position	:	PROVIDER
Name	:	MS. MARY FARSON CULLITON
Credential	:	PMHNP
Telephone Number	:	617-915-5268

Provider Enumeration Date	:	12/23/2025
Last Update Date	:	12/23/2025

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