| Psyched Group, Llc | |
|
205 W Grove St Ste B2 Middleboro MA 02346-1462 | |
| (617) 657-9838 | |
| (888) 978-4883 |
| Full Name | Psyched Group, Llc |
|---|---|
| Speciality | Counselor |
| Location | 205 W Grove St Ste B2, Middleboro, Massachusetts |
| Authorized Official Name and Position | Kenneth N Beaupre (PRACTICE MANAGER) |
| Authorized Official Contact | 6176579838 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psyched Group, Llc 205 W Grove St Suite B Middleboro MA 02346-1462 Ph: (800) 273-6277 | Psyched Group, Llc 205 W Grove St Ste B2 Middleboro MA 02346-1462 Ph: (617) 657-9838 |
| NPI Number | 1386039105 |
|---|---|
| Provider Enumeration Date | 03/30/2015 |
| Last Update Date | 10/22/2015 |
| Medicare PECOS PAC ID | 0941506331 |
|---|---|
| Medicare Enrollment ID | O20160310001822 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386039105 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MHC00668 (Rhode Island) | Primary |
| Provider Name | Darcy Desautels |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538295563 PECOS PAC ID: 2961547468 Enrollment ID: I20100309000318 |
| Provider Name | Dana M Nasser-tobin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497121560 PECOS PAC ID: 5496083172 Enrollment ID: I20190819002898 |
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