Healthcare Provider Details

I. General information

NPI: 1477567451
Provider Name (Legal Business Name): PRESCOTT HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 ELM ST
WORCESTER MA
01609-1903
US

IV. Provider business mailing address

130 ELM ST
WORCESTER MA
01609-1903
US

V. Phone/Fax

Practice location:
  • Phone: 508-754-1803
  • Fax: 508-792-9713
Mailing address:
  • Phone: 508-754-1803
  • Fax: 508-792-9713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MOHAMAD R OCH
Title or Position: GENERAL MANAGING PARTNER
Credential: M.D.
Phone: 508-754-1803