Healthcare Provider Details

I. General information

NPI: 1982564514
Provider Name (Legal Business Name): TABITHA WANJIRU MUCHAI-KAHURA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2025
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

299 LINCOLN ST STE 201
WORCESTER MA
01605-3646
US

IV. Provider business mailing address

18 RIDGEWOOD DR
AUBURN MA
01501-2317
US

V. Phone/Fax

Practice location:
  • Phone: 774-364-7585
  • Fax:
Mailing address:
  • Phone: 774-364-7585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1982564514
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: