| Tara Burgess, | |
| 
					357 Nashawtuc Rd, Concord, MA 01742-1616  | |
| (339) 201-1765 | |
| Not Available | 
| Full Name | Tara Burgess | 
|---|---|
| Gender | Female | 
| Speciality | Counselor - Mental Health | 
| Location | 357 Nashawtuc Rd, Concord, Massachusetts | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1487263281 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary | 
| Entity Name | Youth Opportunities Upheld Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1245317205 PECOS PAC ID: 9638190374 Enrollment ID: O20051209000469  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Tara Burgess, 357 Nashawtuc Rd, Concord, MA 01742-1616 Ph: (339) 201-1765  | Tara Burgess, 357 Nashawtuc Rd, Concord, MA 01742-1616 Ph: (339) 201-1765  | 
Judith Glixon, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 111 Old Road To 9 Acre Cor, Concord, MA 01742 Phone: 978-369-1113 Fax: 978-369-0908  | |
Mr. Jeff C Desjarlais,  Counselor Medicare: Not Enrolled in Medicare Practice Location: 185 Main St, Concord, MA 01742 Phone: 978-402-2336  | |
Constance Dimarino, M.S. Counselor Medicare: Not Enrolled in Medicare Practice Location: 111 Old Road To 9 Acre Cor, Concord, MA 01742 Phone: 978-369-1113  | |
Mr. Christopher Hardiman, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 111 Old Road To 9 Acre Cor, Concord, MA 01742 Phone: 978-369-1113 Fax: 978-369-0908  | |
Nicole Sheehan,  Counselor Medicare: Not Enrolled in Medicare Practice Location: 86 Baker Avenue Ext Ste 100, Concord, MA 01742 Phone: 978-369-1113 Fax: 978-369-0908  | |
Kristen Kenney,  Counselor Medicare: Not Enrolled in Medicare Practice Location: 236 Partridge Ln, Concord, MA 01742 Phone: 617-763-7200  | |
Gabrielle Kosta,  Counselor Medicare: Not Enrolled in Medicare Practice Location: 86 Baker Avenue Ext Ste 100, Concord, MA 01742 Phone: 978-369-1113 Fax: 978-369-0908  |