Organization
BREAKWATER PSYCHIATRY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEGAN ANN CAVANAUGH NURSE PRACTITIONER (OWNER)
(781) 205-9496
Entity
Organization
Contact information
Practice address
440 HUMPHREY ST, SWAMPSCOTT, MA 01907-2574
(781) 205-9496
Mailing address
17 PARADISE ROAD, VINNIN SQUARE PLAZA #1021, SALEM, MA 01970
(781) 205-9496
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
02/03/2023
Last updated
02/03/2023
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