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Organization
STARTING LINE WELLNESS, LLC
Active
Organization
STARTING LINE WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRADFORD ROLPH (MEMBER/MANAGER)
(508) 435-1250
Entity
Organization
Contact information
Practice address
50 W MAIN ST, HOPKINTON, MA 01748-1672
(508) 435-1250
(508) 435-2213
Mailing address
50 W MAIN ST, HOPKINTON, MA 01748-1672
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
NULL
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
—
NULL
103TC0700X
Clinical Psychologist
—
—
103TC1900X
Counseling Psychologist
—
NULL
103TC1900X
Counseling Psychologist
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
363LP2300X
Primary Care Nurse Practitioner
—
NULL
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
02/26/2019
Last updated
02/26/2019
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