Healthcare Provider Details

I. General information

NPI: 1023144995
Provider Name (Legal Business Name): PAUL MICHAEL AMATO LICSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 05/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 PLANTATION ST
WORCESTER MA
01604-3023
US

IV. Provider business mailing address

258 W SUTTON RD
SUTTON MA
01590-1206
US

V. Phone/Fax

Practice location:
  • Phone: 508-849-5600
  • Fax:
Mailing address:
  • Phone: 508-892-7245
  • Fax: 508-892-1152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number214191
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: