Integrated Counseling Centers, Inc. | |
64 Industrial Park Rd Plymouth MA 02360-4829 | |
(508) 830-9562 | |
(508) 830-6735 |
Full Name | Integrated Counseling Centers, Inc. |
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Speciality | Social Worker |
Location | 64 Industrial Park Rd, Plymouth, Massachusetts |
Authorized Official Name and Position | Elizabeth M Ryan (PRESIDENT) |
Authorized Official Contact | 5088309562 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Integrated Counseling Centers, Inc. 64 Industrial Park Rd Plymouth MA 02360-4829 Ph: (508) 830-9562 | Integrated Counseling Centers, Inc. 64 Industrial Park Rd Plymouth MA 02360-4829 Ph: (508) 830-9562 |
NPI Number | 1649254954 |
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Provider Enumeration Date | 11/30/2005 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 3476580986 |
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Medicare Enrollment ID | O20050726000629 |
Identifier | Type | State | Issuer |
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1649254954 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103TC1900X | Psychologist - Counseling | 4342 (Massachusetts) | Primary |
1041C0700X | Social Worker - Clinical | 105196 (Massachusetts) | Primary |
Provider Name | Timothy J Ryan |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1528042850 PECOS PAC ID: 4486670809 Enrollment ID: I20051014000751 |
Provider Name | Elizabeth M Ryan |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1306885652 PECOS PAC ID: 9931125200 Enrollment ID: I20051017000896 |
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