Healthcare Provider Details

I. General information

NPI: 1811502966
Provider Name (Legal Business Name): R.E.S.T. COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2020
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 WEST ST
MILLBURY MA
01527-2676
US

IV. Provider business mailing address

36 TIRRELL ST # 1
WORCESTER MA
01603-2617
US

V. Phone/Fax

Practice location:
  • Phone: 774-243-2621
  • Fax:
Mailing address:
  • Phone: 774-243-2621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
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: MR. LEONARD JUSME
Title or Position: DIRECTOR
Credential: LMHC
Phone: 774-243-2621