| Light House Behavioral Health And Wellness Center Inc. | |
|
1 Westinghouse Plaza A-216 Boston MA 02136 | |
| (617) 839-7392 | |
| Not Available |
| Full Name | Light House Behavioral Health And Wellness Center Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1 Westinghouse Plaza, Boston, Massachusetts |
| Authorized Official Name and Position | Shirley Janvier (CEO, OPERATION MANAGER) |
| Authorized Official Contact | 6178397392 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Light House Behavioral Health And Wellness Center Inc. 21 Kingsbrook Way North Easton MA 02356-2545 Ph: (617) 839-7392 | Light House Behavioral Health And Wellness Center Inc. 1 Westinghouse Plaza A-216 Boston MA 02136 Ph: (617) 839-7392 |
| NPI Number | 1134622426 |
|---|---|
| Provider Enumeration Date | 03/13/2018 |
| Last Update Date | 03/17/2018 |
| Medicare PECOS PAC ID | 6406198712 |
|---|---|
| Medicare Enrollment ID | O20200623001470 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134622426 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Massachusetts) | Primary |
| Provider Name | Edith S Pepper |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033428495 PECOS PAC ID: 5890976559 Enrollment ID: I20110301000320 |
| Provider Name | Josephine Saint Cyr Saieh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770879157 PECOS PAC ID: 6204132558 Enrollment ID: I20160311001647 |
| Provider Name | George P Haywood |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104146893 PECOS PAC ID: 7113348418 Enrollment ID: I20200521002187 |
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