MENDED ROOT NPI 1053095117

NPI Information

  • NPI: 1053095117
  • Provider Name: MENDED ROOT
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Organization
  • Address: 6 LIBERTY SQUARE PMB 6181
    BOSTON, MA
    ZIP 02109
  • Phone: (802) 500-1114

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NPI Details

MENDED ROOT is a psychiatric/mental health nurse practitioner in Boston, MA. MENDED ROOT NPI is 1053095117. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6 LIBERTY SQUARE PMB 6181
BOSTON, MA
ZIP 02109-800
Phone: (802) 500-1114

The provider's authorized official is Michelle Cataldo .
The authorized official title is Practioner and has the following contact phone number (617) 212-0938.

The enumeration date for this NPI number is 6/9/2023 and was last updated on 6/9/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

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