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111 Speen St Ste 110 Framingham MA 01701-2000 | |
| (508) 290-5156 | |
| (508) 443-6024 |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 111 Speen St Ste 110, Framingham, Massachusetts |
| Authorized Official Name and Position | Sarah Ann Prevelige (CLINIC DIRECTOR) |
| Authorized Official Contact | 5084780126 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
111 Speen St Ste 110 Framingham MA 01701-2000 Ph: (508) 290-5156 | 111 Speen St Ste 110 Framingham MA 01701-2000 Ph: (508) 290-5156 |
| NPI Number | 1265290886 |
|---|---|
| Provider Enumeration Date | 03/08/2024 |
| Last Update Date | 10/25/2024 |
| Certification Date | 10/25/2024 |
| Medicare PECOS PAC ID | 3476089509 |
|---|---|
| Medicare Enrollment ID | O20241212000042 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265290886 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| Provider Name | Sarah Ann Prevelige |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265668818 PECOS PAC ID: 4385170414 Enrollment ID: I20241212000064 |
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