| 1722 Behavior & Counseling | |
|
7 Hazelwood Rd Worcester MA 01609-1550 | |
| (774) 570-0431 | |
| Not Available |
| Full Name | 1722 Behavior & Counseling |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 7 Hazelwood Rd, Worcester, Massachusetts |
| Authorized Official Name and Position | Daryle Joel Roberts (CHIEF OPERATING OFFICE) |
| Authorized Official Contact | 7745700431 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 1722 Behavior & Counseling 7 Hazelwood Rd Worcester MA 01609-1550 Ph: (774) 570-0431 | 1722 Behavior & Counseling 7 Hazelwood Rd Worcester MA 01609-1550 Ph: (774) 570-0431 |
| NPI Number | 1346978491 |
|---|---|
| Provider Enumeration Date | 08/08/2022 |
| Last Update Date | 08/15/2022 |
| Certification Date | 08/15/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346978491 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
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