MEDICARE: REDISCOVERY THERAPY

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1427794890
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REDISCOVERY THERAPY

Provider Business Mailing Address
First Line	:	11 HADWEN RD
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01602-2924
Country	:	US
Telephone Number	:	845-741-5882
Fax Number	:

Provider Business Practice Location Address
First Line	:	11 HADWEN RD
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01602-2924
Country	:	US
Telephone Number	:	845-741-5882
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING SPECIALIST
Name	:	MEGHAN ROE
Credential	:
Telephone Number	:	617-674-3499

Provider Enumeration Date	:	05/09/2022
Last Update Date	:	05/09/2022

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Directions to “REDISCOVERY THERAPY ” Practice Location

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