=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255596250
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARCI E. DEUTSCH LMHC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/20/2008
-----------------------------------------------------
Last Update Date | 07/20/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 81 PLANTATION ST
-----------------------------------------------------
City | WORCESTER
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01604-3069
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-849-5600
-----------------------------------------------------
Fax | 508-849-5617
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9 TRINITY AVE
-----------------------------------------------------
City | GRAFTON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01519-1004
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 617-642-2481
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 5991
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------