Provider Demographics
NPI:1528518875
Name:COUNSELING & ASSESSMENT CLINIC OF WORCESTER, LLC
Entity type:Organization
Organization Name:COUNSELING & ASSESSMENT CLINIC OF WORCESTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:HYLTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-756-5400
Mailing Address - Street 1:38 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1732
Mailing Address - Country:US
Mailing Address - Phone:508-756-5400
Mailing Address - Fax:
Practice Address - Street 1:38 FRONT ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1732
Practice Address - Country:US
Practice Address - Phone:508-756-5400
Practice Address - Fax:508-756-5433
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNSELING & ASSESSMENT CLINIC OF WORCESTER, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-11
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management