Healthcare Provider Details
I. General information
NPI: 1497532048
Provider Name (Legal Business Name): NEW HEIGHTS NEUROPSYCHOLOGY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/08/2023
Last Update Date: 09/06/2024
Certification Date: 09/06/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
51 UNION ST STE 222
WORCESTER MA
01608-1147
US
IV. Provider business mailing address
51 UNION ST STE 110
WORCESTER MA
01608-1134
US
V. Phone/Fax
- Phone: 508-635-4360
- Fax: 508-475-9579
- Phone: 508-974-3534
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103G00000X |
| Taxonomy | Clinical Neuropsychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TESSA
HAYES
Title or Position: MEMBER/MANAGER
Credential: LICSW
Phone: 508-635-4360