Lakeside Mental Health, PLLC
Nurse Practitioner, Psych/Mental Health in Lakeville, Massachusetts
1619494168- Practice location
- 104 Charles Eldridge Drive Ste 1, Lakeville, MA 02347-1388
- Phone
- 774-213-9332
- Fax
- —
- Last updated
- August 25, 2017
Lakeside Mental Health, PLLC is a healthcare organization based in Lakeville, MA. Lakeside Mental Health, PLLC practices in Lakeville, MA. The NPI Number for Lakeside Mental Health, PLLC is 1619494168 and holds a License No. 2992320 (MA). The current practice location address for Lakeside Mental Health, PLLC is 104 Charles Eldridge Drive Ste 1, Lakeville, MA 02347-1388 and can be reached out via phone at 774-213-9332.
Provider Profile Details
- NPI Number
- 1619494168
- Provider Name
- Lakeside Mental Health, PLLC
- Provider Entity Type
- Organization
- Address
- 104 Charles Eldridge Drive Ste 1, Lakeville, MA 02347-1388
- Phone Number
- 774-213-9332
- Primary Taxonomy
- Nurse Practitioner, Psych/Mental Health · 363LP0808X
- Organization Subpart
- No
- Authorized Official
- Mrs. Emily-Rose Montgomery Virden, PMHNP-BC · Owner/ Nurse Practitioner · 774-213-9332
- Provider Enumeration Date
- August 25, 2017
- Last Update Date
- August 25, 2017
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 104 Charles Eldridge Drive Ste 1
Lakeville, MA 02347-1388 - City
- Lakeville
- State
- Massachusetts
- Zip
- 02347-1388
- Phone Number
- 774-213-9332
Provider Business Mailing Address Details
- Address
- 104 Charles Eldridge Drive Ste 1
Lakeville, MA 02347 - City
- Lakeville
- State
- MA
- Zip
- 02347
License Information
- License Number
- 2992320
- License State
- MA
- Taxonomy
- Nurse Practitioner, Psych/Mental Health · 363LP0808X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Lakeside Mental Health, PLLC?
The NPI number of Lakeside Mental Health, PLLC is 1619494168. It was assigned on August 25, 2017 and is currently active in the NPPES registry.
What is the specialty of Lakeside Mental Health, PLLC?
Lakeside Mental Health, PLLC is registered under the primary taxonomy Nurse Practitioner, Psych/Mental Health (code 363LP0808X), licensed in MA under license number 2992320.
Where does Lakeside Mental Health, PLLC practice?
The practice location is 104 Charles Eldridge Drive Ste 1, Lakeville, MA 02347-1388. The office can be reached at 774-213-9332 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1619494168 directly on the NPPES registry website.