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General NPI Number Information
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NPI Number | 1962526566
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Entity Type | Organization
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Legal Business Name | MENTAL HEALTH AFFILIATES
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1290 WORCESTER RD
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City | FRAMINGHAM
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State | MA
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Zip | 01702-5254
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Country | US
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Telephone | 508-872-1650
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Fax | 508-370-7282
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Provider Business Mailing Address
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Address Line | 1290 WORCESTER RD
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City | FRAMINGHAM
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State | MA
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Zip | 01702-5254
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Country | US
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Telephone | 508-872-1650
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Fax | 508-370-7282
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | TERI SORENSON
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Credential |
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Telephone | 508-872-6228
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 110375
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License Number State | MA
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