| Till, Inc. | |
|
20 Eastbrook Rd Dedham MA 02026-2075 | |
| (781) 302-4604 | |
| (781) 234-1104 |
| Full Name | Till, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 20 Eastbrook Rd, Dedham, Massachusetts |
| Authorized Official Name and Position | Kevin M Stock (VICE PRESIDENT - OPERATIONS) |
| Authorized Official Contact | 7813024604 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Till, Inc. 20 Eastbrook Rd Dedham MA 02026-2075 Ph: (781) 302-4604 | Till, Inc. 20 Eastbrook Rd Dedham MA 02026-2075 Ph: (781) 302-4604 |
| NPI Number | 1992898035 |
|---|---|
| Provider Enumeration Date | 10/02/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 6103831979 |
|---|---|
| Medicare Enrollment ID | O20060215000402 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992898035 | NPI | - | NPPES |
| 1309625 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Suzanne R Posner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023087848 PECOS PAC ID: 3375577182 Enrollment ID: I20050921000721 |
| Provider Name | Mahmood Hussain Sharfi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154311611 PECOS PAC ID: 6901823897 Enrollment ID: I20051031000248 |
| Provider Name | Karen J Shedlack |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417999434 PECOS PAC ID: 5698865533 Enrollment ID: I20071217000147 |
| Provider Name | Fay Reich |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629121751 PECOS PAC ID: 8022186717 Enrollment ID: I20081008000226 |
| Provider Name | Irene T Manfredo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225243215 PECOS PAC ID: 2466646013 Enrollment ID: I20121025000734 |
| Provider Name | Maris F Salinsky |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093801045 PECOS PAC ID: 1052631017 Enrollment ID: I20150515000195 |
| Provider Name | Robin Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699916155 PECOS PAC ID: 2769781657 Enrollment ID: I20160427001493 |
| Provider Name | Diane M Mcavoy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104117506 PECOS PAC ID: 1254666522 Enrollment ID: I20190709000806 |
| Provider Name | Ruth S Benning |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003214735 PECOS PAC ID: 2769865773 Enrollment ID: I20220823003367 |
| Provider Name | Brigid Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396113304 PECOS PAC ID: 0345615159 Enrollment ID: I20230410001588 |
| Provider Name | Joseph Gardner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053372490 PECOS PAC ID: 0547609752 Enrollment ID: I20240422001127 |
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