MEDICARE: EMOTIONAL STEP UP HEALTH SYSTEMS LLC

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	:	1912529355
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMOTIONAL STEP UP HEALTH SYSTEMS LLC

Provider Business Mailing Address
First Line	:	14-16 FLETCHER ST STE 9
Second Line	:
City	:	CHELMSFORD
State	:	MA
Zip	:	01824-2713
Country	:	US
Telephone Number	:	978-726-8661
Fax Number	:	978-735-4639

Provider Business Practice Location Address
First Line	:	14-16 FLETCHER ST STE 9
Second Line	:
City	:	CHELMSFORD
State	:	MA
Zip	:	01824-2713
Country	:	US
Telephone Number	:	978-726-8661
Fax Number	:	978-735-4639

Authorized Official
Title or Position	:	NURSE PRACTITIONER
Name	:	MRS. ANN W WANDERI
Credential	:	PMHNP
Telephone Number	:	978-735-4640

Provider Enumeration Date	:	05/07/2020
Last Update Date	:	07/12/2024

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