Mr Jeff Citro, MA, MDIV | |
1115 W Chestnut St, Brockton, MA 02301-7501 | |
(508) 580-4691 | |
Not Available |
Full Name | Mr Jeff Citro |
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Gender | Male |
Speciality | Counselor - Professional |
Location | 1115 W Chestnut St, Brockton, Massachusetts |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1568716918 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
101YP2500X | Counselor - Professional | LPC.0015804 (Colorado) | Primary |
Entity Name | Heart Of Boardwalk |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1134129034 PECOS PAC ID: 4789575614 Enrollment ID: O20040322000950 |
Mailing Address | Practice Location Address |
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Mr Jeff Citro, MA, MDIV 1283 Kelly Johnson Blvd, Colorado Springs, CO 80920-3925 Ph: (719) 413-6776 | Mr Jeff Citro, MA, MDIV 1115 W Chestnut St, Brockton, MA 02301-7501 Ph: (508) 580-4691 |
Mrs. Neena Nicole Mcconnico, M.A., LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 95 River St, Brockton, MA 02302 Phone: 508-580-8546 | |
Cecilia Vicente, Counselor Medicare: Not Enrolled in Medicare Practice Location: 231 Main St, Suite 300, Brockton, MA 02301 Phone: 508-586-2660 Fax: 508-427-1505 | |
Krista Hojlo, MSW, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 67 Brian Dr, Brockton, MA 02301 Phone: 508-245-1566 | |
Pamela Cummisky, Counselor Medicare: Not Enrolled in Medicare Practice Location: 30 Meadowbrook Rd, Brockton, MA 02301 Phone: 774-628-1000 | |
Thalia Dominguez, NREMT, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 56 Cherry St, Brockton, MA 02301 Phone: 508-580-0801 | |
Janice Marie Johnson-plumer, Counselor Medicare: Not Enrolled in Medicare Practice Location: 231 Main St Fl 3, Brockton, MA 02301 Phone: 508-586-2660 | |
Deborah G Stromberg, Counselor Medicare: Not Enrolled in Medicare Practice Location: 37 Belmont St, Brockton, MA 02301 Phone: 508-580-4691 Fax: 508-588-5751 |