Provider Demographics
NPI:1699576769
Name:MELROSE-WAKEFIELD PSYCHIATRIC ASSOCIATES, PLLC
Entity type:Organization
Organization Name:MELROSE-WAKEFIELD PSYCHIATRIC ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SALWA
Authorized Official - Middle Name:V
Authorized Official - Last Name:RAOUI
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:781-600-2315
Mailing Address - Street 1:7 LINCOLN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-3033
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:781-327-6308
Practice Address - Street 1:7 LINCOLN ST STE 201
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-3033
Practice Address - Country:US
Practice Address - Phone:781-423-3208
Practice Address - Fax:781-327-6308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty