Healthcare Provider Details

I. General information

NPI: 1255596250
Provider Name (Legal Business Name): MARCI E. DEUTSCH LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2008
Last Update Date: 07/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 PLANTATION ST
WORCESTER MA
01604-3069
US

IV. Provider business mailing address

9 TRINITY AVE
GRAFTON MA
01519-1004
US

V. Phone/Fax

Practice location:
  • Phone: 508-849-5600
  • Fax: 508-849-5617
Mailing address:
  • Phone: 617-642-2481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5991
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: