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NPI Code Detail

MEDICARE: REBEKAH TATRO LICSW

MEDICARE: REBEKAH TATRO LICSW
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
11041C0700XClinical Social Worker223931MA

General Provider Information

NPI Number : 1962984500
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBEKAH TATRO LICSW
Provider Business Mailing Address
First Line : 24 CRESTVIEW LN
Second Line :
City : FITCHBURG
State : MA
Zip : 01420-6308
Country : US
Telephone Number : 978-751-5273
Fax Number :
Provider Business Practice Location Address
First Line : 47 ASHBY STATE RD
Second Line :
City : FITCHBURG
State : MA
Zip : 01420-2038
Country : US
Telephone Number : 617-545-7504
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2018
Last Update Date : 05/01/2025

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Directions to “ REBEKAH TATRO LICSW” Practice Location

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