| Constellations Psychological Services Llc | |
|
1078 Main St Leicester MA 01524-1396 | |
| (508) 470-1505 | |
| Not Available |
| Full Name | Constellations Psychological Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1078 Main St, Leicester, Massachusetts |
| Authorized Official Name and Position | Tracey Rocha Phelon (OWNER/PSYCHOLOGIST) |
| Authorized Official Contact | 5084701505 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Constellations Psychological Services Llc 1078 Main St Leicester MA 01524-1396 Ph: () - | Constellations Psychological Services Llc 1078 Main St Leicester MA 01524-1396 Ph: (508) 470-1505 |
| NPI Number | 1528671740 |
|---|---|
| Provider Enumeration Date | 08/27/2020 |
| Last Update Date | 08/27/2020 |
| Certification Date | 08/27/2020 |
| Medicare PECOS PAC ID | 9537579206 |
|---|---|
| Medicare Enrollment ID | O20201109001080 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528671740 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Tracey Rocha Phelon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538583745 PECOS PAC ID: 4082838552 Enrollment ID: I20140624002044 |
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