Provider Demographics
NPI:1730687385
Name:PRIMULA HEALTH LLC
Entity type:Organization
Organization Name:PRIMULA HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:KAMIN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:503-407-4144
Mailing Address - Street 1:292 NEWBURY ST # 313
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-2863
Mailing Address - Country:US
Mailing Address - Phone:617-908-7172
Mailing Address - Fax:
Practice Address - Street 1:399 BOYLSTON ST STE 900
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-3305
Practice Address - Country:US
Practice Address - Phone:503-407-4144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-29
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10206103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty