| Revidas | |
|
108 Grove Street Suite Ll11 Worcester MA 01605-2677 | |
| (508) 304-7499 | |
| (774) 420-7255 |
| Full Name | Revidas |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 108 Grove Street, Worcester, Massachusetts |
| Authorized Official Name and Position | Geoffrey Cushner (MANAGING DIRECTOR) |
| Authorized Official Contact | 5083047499 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revidas 108 Grove Street Suite Ll11 Worcester MA 01605-2677 Ph: (508) 304-7499 | Revidas 108 Grove Street Suite Ll11 Worcester MA 01605-2677 Ph: (508) 304-7499 |
| NPI Number | 1528410610 |
|---|---|
| Provider Enumeration Date | 07/12/2016 |
| Last Update Date | 10/01/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528410610 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 3875 (Massachusetts) | Primary |
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