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General NPI Number Information
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NPI Number | 1720956931
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Entity Type | Organization
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Legal Business Name | PSYCHOLOGY GROUP OF NEW ENGLAND, LLC
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Dates
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Enumeration Date | 10/28/2025
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 25 ROCKY HILL RD
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City | NORTH SMITHFIELD
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State | RI
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Zip | 02896-8117
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Country | US
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Telephone | 813-359-1995
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Fax |
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Provider Business Mailing Address
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Address Line | 6515 N ARMENIA AVE
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City | TAMPA
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State | FL
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Zip | 33604-5713
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Country | US
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Telephone | 813-359-1995
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Fax | 813-702-1933
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Authorized Official
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Title or Position | CEO, CO-OWNER
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Name | MICHAEL FRITZ WUSIK
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Credential | PHD
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Telephone | 315-527-1462
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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