Healthcare Provider Details

I. General information

NPI: 1043942139
Provider Name (Legal Business Name): WORCESTER COUNTY COUNSELING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2022
Last Update Date: 06/27/2022
Certification Date: 06/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 W MAIN ST
DUDLEY MA
01571-3817
US

IV. Provider business mailing address

3 JUNIPER LN
DUDLEY MA
01571-3826
US

V. Phone/Fax

Practice location:
  • Phone: 774-757-2254
  • Fax: 508-949-6731
Mailing address:
  • Phone: 774-757-2254
  • Fax: 508-949-6731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. HOLLY C POIRIER
Title or Position: OWNER/CLINICIAN
Credential: CAGS LMHC
Phone: 774-757-2254