Basic Information
| Provider Information | |||||||||
| NPI: | 1215127840 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NELSON-VANCINI | ||||||||
| FirstName: | MARCIA | ||||||||
| MiddleName: | ELAINE | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | CNS NP | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | VANCINI | ||||||||
| OtherFirstName: | MARCIA | ||||||||
| OtherMiddleName: | ELAINE | ||||||||
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| OtherCredential: | CNS NP | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2 BRENTWOOD CIR | ||||||||
| Address2: | |||||||||
| City: | ANDOVER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018105129 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9783358785 | ||||||||
| FaxNumber: | 9784702282 | ||||||||
| Practice Location | |||||||||
| Address1: | LAHEY HEALTH BEHAVIORAL SERVICES, INC. | ||||||||
| Address2: | 12 METHUEN STREET | ||||||||
| City: | LAWRENCE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01840 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9786833128 | ||||||||
| FaxNumber: | 9789890019 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/30/2007 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 100572 | MA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 364SP0809X | 100572 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Psych/Mental Health, Adult |
No ID Information.