Healthcare Provider Details

I. General information

NPI: 1467743088
Provider Name (Legal Business Name): ASSESSMENT AND TREATMENT ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2011
Last Update Date: 04/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 NATHAN ELLIS HWY
MASHPEE MA
02649-3121
US

IV. Provider business mailing address

400 NATHAN ELLIS HWY SUITE 1
MASHPEE MA
02649-3121
US

V. Phone/Fax

Practice location:
  • Phone: 401-624-7281
  • Fax: 401-624-7208
Mailing address:
  • Phone: 401-624-7281
  • Fax: 401-624-7208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1016742
License Number StateMA

VIII. Authorized Official

Name: DR. ROBERT MARTIN DU WORS
Title or Position: PRESIDENT
Credential: PHD
Phone: 401-624-7281