| Integrated Counseling Centers, Inc. | |
|
64 Industrial Park Rd Plymouth MA 02360-4829 | |
| (508) 830-9562 | |
| (508) 830-6735 |
| Full Name | Integrated Counseling Centers, Inc. |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 11/30/2005 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 3476580986 |
|---|---|
| Medicare Enrollment ID | O20050726000629 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649254954 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | 4342 (Massachusetts) | Primary |
| 1041C0700X | Social Worker - Clinical | 105196 (Massachusetts) | Primary |
| Provider Name | Timothy J Ryan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528042850 PECOS PAC ID: 4486670809 Enrollment ID: I20051014000751 |
| Provider Name | Elizabeth M Ryan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306885652 PECOS PAC ID: 9931125200 Enrollment ID: I20051017000896 |
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