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General NPI Number Information
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NPI Number | 1235672577
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Entity Type | Organization
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Legal Business Name | SANDMAN COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 11/18/2016
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Last Update Date | 11/18/2016
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Provider Practice Location Address
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Address Line | 100 GROVE ST 306
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City | WORCESTER
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State | MA
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Zip | 01605-2627
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Country | US
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Telephone | 774-329-9429
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Fax |
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Provider Business Mailing Address
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Address Line | 100 GROVE ST 306
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City | WORCESTER
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State | MA
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Zip | 01605-2627
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Country | US
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Telephone | 774-329-9429
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAUL HARRIS SANDMAN
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Credential | ED.D. L.M.H.C.
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Telephone | 774-329-9429
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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 | 7074
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License Number State | MA
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