# STARTING LINE WELLNESS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003373069
- **Authorized official:** MR. BRADFORD ROLPH (MEMBER/MANAGER)
- **Authorized official phone:** (508) 435-1250

## Contact information

- **Practice address:** 50 W MAIN ST, HOPKINTON, MA 01748-1672
- **Practice address phone:** (508) 435-1250
- **Practice address fax:** (508) 435-2213
- **Mailing address:** 50 W MAIN ST, HOPKINTON, MA 01748-1672

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 02/26/2019
- **Last updated:** 02/26/2019