Healthcare Provider Details

I. General information

NPI: 1891860946
Provider Name (Legal Business Name): PARK PLACE ASSOCIATES, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 PARK AVE
WORCESTER MA
01605-3911
US

IV. Provider business mailing address

20 PARK AVE
WORCESTER MA
01605-3911
US

V. Phone/Fax

Practice location:
  • Phone: 508-753-4344
  • Fax: 508-753-1785
Mailing address:
  • Phone: 508-753-4344
  • Fax: 508-753-1785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DR. DOUGLAS A. TAYLOR
Title or Position: MANAGING PARTNER
Credential: PH.D.
Phone: 508-363-4900