MEDICARE: ONE FOUR COUNSELING SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1043165798
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ONE FOUR COUNSELING SERVICES LLC

Provider Business Mailing Address
First Line	:	10 WARWICK ST
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01610-2223
Country	:	US
Telephone Number	:	774-275-0112
Fax Number	:	774-256-2232

Provider Business Practice Location Address
First Line	:	10 WARWICK ST
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01610-2223
Country	:	US
Telephone Number	:	774-275-0112
Fax Number	:	774-256-2232

Authorized Official
Title or Position	:	CEO
Name	:	PETER ANDERSON
Credential	:	LICSW
Telephone Number	:	774-275-0112

Provider Enumeration Date	:	02/27/2026
Last Update Date	:	02/27/2026

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