# NORTHEAST MEDICAL GROUP, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Northeast Mental Wellness
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104575166
- **Authorized official:** SACHIN B PATEL MD (PRESIDENT)
- **Authorized official phone:** (978) 710-4242

## Contact information

- **Practice address:** 275 VARNUM AVE STE 108, LOWELL, MA 01854-2117
- **Practice address phone:** (978) 710-4242
- **Practice address fax:** (978) 710-4202
- **Mailing address:** 275 VARNUM AVE STE 108, LOWELL, MA 01854-2117
- **Mailing address phone:** (978) 710-4242
- **Mailing address fax:** (978) 710-4202

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 103TC0700X | Clinical Psychologist | — | NULL | — |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 163WP0809X | Adult Psychiatric/Mental Health Registered Nurse | — | NULL | Yes |
| 163WP0809X | Adult Psychiatric/Mental Health Registered Nurse | — | — | Yes |
| 364SP0809X | Adult Psychiatric/Mental Health Clinical Nurse Specialist | — | NULL | — |
| 364SP0809X | Adult Psychiatric/Mental Health Clinical Nurse Specialist | — | — | — |

## Other

- **Enumeration date:** 03/18/2022
- **Last updated:** 03/18/2022