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General NPI Number Information
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NPI Number | 1063172740
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Entity Type | Organization
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Legal Business Name | NEW BEGINNINGS GROUP PRACTICE LLC
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Dates
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Enumeration Date | 12/22/2021
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Last Update Date | 12/22/2021
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Provider Practice Location Address
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Address Line | 1280 MAIN ST
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City | WORCESTER
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State | MA
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Zip | 01603-1861
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Country | US
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Telephone | 508-754-1141
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Fax | 508-754-1115
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Provider Business Mailing Address
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Address Line | 1280 MAIN ST
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City | WORCESTER
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State | MA
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Zip | 01603-1861
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Country | US
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Telephone | 508-754-1141
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Fax | 508-754-1115
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | SHERRI ANN MECUM
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Credential | LMHC
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Telephone | 508-254-2384
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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