MEDICARE: SOUTH COUNTY PSYCHIATRIC & PSYCHOTHERAPY CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225098239
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH COUNTY PSYCHIATRIC & PSYCHOTHERAPY CENTER

Provider Business Mailing Address
First Line	:	20 LEWIS AVE
Second Line	:
City	:	GT BARRINGTON
State	:	MA
Zip	:	01230
Country	:	US
Telephone Number	:	413-528-1845
Fax Number	:	413-528-3667

Provider Business Practice Location Address
First Line	:	20 LEWIS AVE
Second Line	:
City	:	GT BARRINGTON
State	:	MA
Zip	:	01230
Country	:	US
Telephone Number	:	413-528-1845
Fax Number	:	413-528-3667

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	DR. DENNIS C MARCUS
Credential	:	MD
Telephone Number	:	413-528-1845

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	08/22/2020

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