| Enlightened Psychiatry, Llc | |
| 
					54 Central St Ste 2 Southborough MA 01745-1032  | |
| (508) 714-7604 | |
| (508) 213-3968 | 
| Full Name | Enlightened Psychiatry, Llc | 
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) | 
| Location | 54 Central St Ste 2, Southborough, Massachusetts | 
| Authorized Official Name and Position | Jean Waitneight (PRACTICE OWNER) | 
| Authorized Official Contact | 6176869802 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Enlightened Psychiatry, Llc 54 Central St Ste 2 Southborough MA 01745-1032 Ph: (508) 714-7604  | Enlightened Psychiatry, Llc 54 Central St Ste 2 Southborough MA 01745-1032 Ph: (508) 714-7604  | 
| NPI Number | 1386280535 | 
|---|---|
| Provider Enumeration Date | 11/22/2019 | 
| Last Update Date | 11/22/2019 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1386280535 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary | 
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