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General NPI Number Information
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NPI Number | 1376380006
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Entity Type | Organization
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Legal Business Name | RESTORE PSYCHOLOGICAL SERVICES, PLLC
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Dates
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Enumeration Date | 07/10/2024
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 12 ST CLAIR RD
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City | BRIMFIELD
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State | MA
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Zip | 01010-2120
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Country | US
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Telephone | 413-245-1487
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Fax | 413-895-6589
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Provider Business Mailing Address
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Address Line | 12 ST CLAIR RD
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City | BRIMFIELD
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State | MA
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Zip | 01010-2120
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Country | US
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Telephone | 413-245-1487
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Fax | 413-895-6589
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Authorized Official
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Title or Position | OWNER
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Name | DR. TINA RENEE ADAMS
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Credential | PH.D.
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Telephone | 413-245-1487
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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