| Beacon Of Hope Therapy And Consultation Services Llc | |
|
21 Ball St Worcester MA 01603-3116 | |
| (508) 769-2117 | |
| Not Available |
| Full Name | Beacon Of Hope Therapy And Consultation Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 21 Ball St, Worcester, Massachusetts |
| Authorized Official Name and Position | Brenda Nagle-packard (OWNER) |
| Authorized Official Contact | 5087692117 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beacon Of Hope Therapy And Consultation Services Llc 21 Ball St Worcester MA 01603-3116 Ph: () - | Beacon Of Hope Therapy And Consultation Services Llc 21 Ball St Worcester MA 01603-3116 Ph: (508) 769-2117 |
| NPI Number | 1962084848 |
|---|---|
| Provider Enumeration Date | 04/21/2021 |
| Last Update Date | 04/21/2021 |
| Certification Date | 04/21/2021 |
| Medicare PECOS PAC ID | 5092189522 |
|---|---|
| Medicare Enrollment ID | O20230323000594 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962084848 | NPI | - | NPPES |
| 120511 | Other | MA | SOCIAL WORK LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Brenda M Nagle-packard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578789996 PECOS PAC ID: 5294006649 Enrollment ID: I20170803003067 |
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