Healthcare Provider Details

I. General information

NPI: 1205211414
Provider Name (Legal Business Name): PERCEPTIONS PSYCHOTHHERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2015
Last Update Date: 07/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

76 SUMMER ST SUITE 335
FITCHBURG MA
01420-5783
US

IV. Provider business mailing address

76 SUMMER ST SUITE 335
FITCHBURG MA
01420-5783
US

V. Phone/Fax

Practice location:
  • Phone: 978-696-5524
  • Fax: 978-696-5534
Mailing address:
  • Phone: 978-696-5524
  • Fax: 978-696-5534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number101YA0400X
License Number StateMA

VIII. Authorized Official

Name: MS. SILVIA MARIE WOODGETT
Title or Position: CLINICIAN OR COUNSELOR
Credential: M. E.D, LADAC1
Phone: 978-652-8590