| Livindi Group Massachusetts | |
|
526 Boston Post Rd Ste 2 Wayland MA 01778-1840 | |
| (508) 416-6030 | |
| Not Available |
| Full Name | Livindi Group Massachusetts |
|---|---|
| Speciality | Social Worker |
| Location | 526 Boston Post Rd Ste 2, Wayland, Massachusetts |
| Authorized Official Name and Position | Richard M Watkins (AO) |
| Authorized Official Contact | 5084166026 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Livindi Group Massachusetts Po Box 70 Wayland MA 01778-0070 Ph: (508) 416-6030 | Livindi Group Massachusetts 526 Boston Post Rd Ste 2 Wayland MA 01778-1840 Ph: (508) 416-6030 |
| NPI Number | 1558147371 |
|---|---|
| Provider Enumeration Date | 09/06/2023 |
| Last Update Date | 09/11/2023 |
| Certification Date | 09/11/2023 |
| Medicare PECOS PAC ID | 5092178616 |
|---|---|
| Medicare Enrollment ID | O20231117000886 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558147371 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Nancy E Funkhouser |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780152926 PECOS PAC ID: 4789040437 Enrollment ID: I20230523000065 |
| Provider Name | Michelle Mainguy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962274720 PECOS PAC ID: 5193172872 Enrollment ID: I20231117001400 |
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