Provider Demographics
NPI:1174715957
Name:SAINTELIEN, CYLLENE ARICE (PMHNP-BC, NP)
Entity type:Individual
Prefix:MRS
First Name:CYLLENE
Middle Name:ARICE
Last Name:SAINTELIEN
Suffix:
Gender:F
Credentials:PMHNP-BC, NP
Other - Prefix:MS
Other - First Name:CYLLENE
Other - Middle Name:
Other - Last Name:HOLMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PMHNP
Mailing Address - Street 1:124 LONG POND RD STE 11B
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-2785
Mailing Address - Country:US
Mailing Address - Phone:617-202-3003
Mailing Address - Fax:617-326-2637
Practice Address - Street 1:124 LONG POND RD STE 11B
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-2785
Practice Address - Country:US
Practice Address - Phone:617-202-3003
Practice Address - Fax:617-326-2637
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MA281148163WP0808X
MA2009011171363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110087393Medicaid