| Dove Emotional Wellness Center | |
|
40 Eastern Ave Ste 202 Malden MA 02148-5030 | |
| (781) 330-2926 | |
| (671) 977-8665 |
| Full Name | Dove Emotional Wellness Center |
|---|---|
| Speciality | Counselor |
| Location | 40 Eastern Ave Ste 202, Malden, Massachusetts |
| Authorized Official Name and Position | Emile Lyns Hercule (CLINICIAN) |
| Authorized Official Contact | 7813302926 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dove Emotional Wellness Center 40 Eastern Ave Ste 202 Malden MA 02148-5030 Ph: (781) 330-2926 | Dove Emotional Wellness Center 40 Eastern Ave Ste 202 Malden MA 02148-5030 Ph: (781) 330-2926 |
| NPI Number | 1790404994 |
|---|---|
| Provider Enumeration Date | 08/23/2022 |
| Last Update Date | 09/26/2022 |
| Certification Date | 09/26/2022 |
| Medicare PECOS PAC ID | 4880070606 |
|---|---|
| Medicare Enrollment ID | O20221003001204 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790404994 | NPI | - | NPPES |
| Provider Name | Lyns Widdy Hercule |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962633735 PECOS PAC ID: 5799161519 Enrollment ID: I20221003001281 |
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