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General NPI Number Information
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NPI Number | 1245609429
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Entity Type | Organization
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Legal Business Name | JILL VETSTEIN
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Dates
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Enumeration Date | 09/17/2015
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Last Update Date | 09/17/2015
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Provider Practice Location Address
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Address Line | 28 GRAFTON CMN
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City | GRAFTON
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State | MA
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Zip | 01519-1534
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Country | US
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Telephone | 508-523-3111
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Fax |
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Provider Business Mailing Address
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Address Line | 1257 WORCESTER RD SUIT 181
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City | FRAMINGHAM
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State | MA
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Zip | 01701-5217
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | MRS. JILL ALAINE VETSTEIN
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Credential | LICSW
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Telephone | 508-523-3111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 113779
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 113779
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | 113779
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 113779
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License Number State | MA
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