Organization
WHITLEY WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEOFFREY WHITLEY NP-C (OWNER)
(617) 620-9757
Entity
Organization
Contact information
Practice address
8 SHIPWAY PL # C-8, CHARLESTOWN, MA 02129-4301
(325) 439-9799
(617) 987-9739
Mailing address
8 SHIPWAY PL # C-8, CHARLESTOWN, MA 02129-4301
(325) 439-9799
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
RN2267850
MA
101YM0800X
Mental Health Counselor
—
—
133V00000X
Registered Dietitian
—
—
163WN1003X
Nutrition Support Registered Nurse
RN2267850
MA
225700000X
Massage Therapist
1099
MA
251S00000X
Community/Behavioral Health Agency
Primary
—
—
363LF0000X
Family Nurse Practitioner
RN2267850
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
03/21/2016
Last updated
03/19/2018
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