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General NPI Number Information
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NPI Number | 1649466582
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Entity Type | Organization
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Legal Business Name | ACADEMY METROWEST, INC.
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Dates
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Enumeration Date | 09/24/2007
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Last Update Date | 09/24/2007
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Provider Practice Location Address
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Address Line | 9 TECH CIR
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City | NATICK
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State | MA
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Zip | 01760-1023
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Country | US
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Telephone | 508-655-9200
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Fax | 508-651-2777
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Provider Business Mailing Address
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Address Line | PO BOX 2131 9 TECH CIRCLE
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City | NATICK
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State | MA
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Zip | 01760-0016
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Country | US
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Telephone | 508-655-9200
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Fax | 508-651-2777
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. BRUCE A. SABIAN
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Credential | M.A., LMHC
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Telephone | 508-655-9200
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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 | 2024
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License Number State | MA
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