Provider Demographics
NPI:1356703169
Name:WHOLE LIVING CENTER
Entity type:Organization
Organization Name:WHOLE LIVING CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:EMILIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SABATOWSKA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:617-981-4287
Mailing Address - Street 1:1158 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-5205
Mailing Address - Country:US
Mailing Address - Phone:617-981-4287
Mailing Address - Fax:
Practice Address - Street 1:1158 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-5205
Practice Address - Country:US
Practice Address - Phone:617-981-4287
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7715101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1528376399OtherINDIVIDUAL NPI