Provider Demographics
NPI:1700565397
Name:MOSAIC MENTAL HEALTH, LLC
Entity type:Organization
Organization Name:MOSAIC MENTAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:781-757-4784
Mailing Address - Street 1:377 WILLARD ST # 317
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-6122
Mailing Address - Country:US
Mailing Address - Phone:781-757-4784
Mailing Address - Fax:
Practice Address - Street 1:167 WASHINGTON ST STE 36
Practice Address - Street 2:
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-1797
Practice Address - Country:US
Practice Address - Phone:781-757-4784
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-12
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)