Provider Demographics
NPI:1215661764
Name:RESILIENT MINDS HEALTH & WELLNESS SERVICES, LLC
Entity type:Organization
Organization Name:RESILIENT MINDS HEALTH & WELLNESS SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC/MENTAL HEALTH CNS
Authorized Official - Prefix:MS
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:J
Authorized Official - Last Name:ECKERT
Authorized Official - Suffix:
Authorized Official - Credentials:PMHCNS-BC
Authorized Official - Phone:978-844-0501
Mailing Address - Street 1:37 WINTER ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01721-1122
Mailing Address - Country:US
Mailing Address - Phone:978-844-0501
Mailing Address - Fax:
Practice Address - Street 1:21 MAIN STREET
Practice Address - Street 2:SUITE 103
Practice Address - City:ASHLAND
Practice Address - State:MA
Practice Address - Zip Code:01721-1231
Practice Address - Country:US
Practice Address - Phone:978-844-0501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-11
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, AdultGroup - Single Specialty