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General NPI Number Information
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NPI Number | 1740657527
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Entity Type | Organization
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Legal Business Name | THE BRIDGE OF CENTRAL MASSACHUSETTS, INC.
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Dates
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Enumeration Date | 08/27/2015
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 288 GROVE ST STE A&B
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City | WORCESTER
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State | MA
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Zip | 01605-3934
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Country | US
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Telephone | 508-755-0333
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Fax | 508-755-2191
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Provider Business Mailing Address
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Address Line | 4 MANN ST
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City | WORCESTER
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State | MA
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Zip | 01602-3414
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Country | US
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Telephone | 508-755-0333
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Fax | 508-755-2191
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Authorized Official
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Title or Position | EVP - CFO AND COO
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Name | MARY BENVENUTO
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Credential |
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Telephone | 508-318-7405
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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 |
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License Number State |
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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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number |
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License Number State |
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Taxonomy #5
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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 |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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