Healthcare Provider Details

I. General information

NPI: 1487256681
Provider Name (Legal Business Name): RAI COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2020
Last Update Date: 11/28/2020
Certification Date: 11/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BOSTON TPKE STE J9B
SHREWSBURY MA
01545-3601
US

IV. Provider business mailing address

100 BOSTON TPKE STE J9B
SHREWSBURY MA
01545-3601
US

V. Phone/Fax

Practice location:
  • Phone: 508-834-3062
  • Fax:
Mailing address:
  • Phone: 508-834-3062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MERCY TANDOH
Title or Position: OWNER
Credential: LMHC
Phone: 508-834-3062