| Mass Counseling Center, Inc | |
|
100 Grove St Ste 301 Worcester MA 01605-2630 | |
| (508) 796-0730 | |
| Not Available |
| Full Name | Mass Counseling Center, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 100 Grove St Ste 301, Worcester, Massachusetts |
| Authorized Official Name and Position | Esie Wilson (CEO) |
| Authorized Official Contact | 5087960730 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mass Counseling Center, Inc 100 Grove St Ste 301 Worcester MA 01605-2630 Ph: (508) 796-0730 | Mass Counseling Center, Inc 100 Grove St Ste 301 Worcester MA 01605-2630 Ph: (508) 796-0730 |
| NPI Number | 1578111530 |
|---|---|
| Provider Enumeration Date | 09/03/2019 |
| Last Update Date | 10/01/2019 |
| Medicare PECOS PAC ID | 2365876885 |
|---|---|
| Medicare Enrollment ID | O20191216002280 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578111530 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Deborah L Floyd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154339950 PECOS PAC ID: 9436102688 Enrollment ID: I20050228000588 |
| Provider Name | Sharon F Divitto |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1720189525 PECOS PAC ID: 3779515861 Enrollment ID: I20050909000424 |
| Provider Name | Stephen Zombil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780165498 PECOS PAC ID: 2668796574 Enrollment ID: I20181226000083 |
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