Healthcare Provider Details

I. General information

NPI: 1265290886
Provider Name (Legal Business Name): METROWEST MENTAL HEALTH SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2024
Last Update Date: 10/25/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 SPEEN ST STE 110
FRAMINGHAM MA
01701-2000
US

IV. Provider business mailing address

111 SPEEN ST STE 110
FRAMINGHAM MA
01701-2000
US

V. Phone/Fax

Practice location:
  • Phone: 508-290-5156
  • Fax: 508-443-6024
Mailing address:
  • Phone: 508-290-5156
  • Fax: 508-443-6024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: SARAH ANN PREVELIGE
Title or Position: CLINIC DIRECTOR
Credential:
Phone: 508-478-0126