| Awareness Therapy Center, Llc | |
|
264 N Main St Ste 1a East Longmeadow MA 01028-1815 | |
| (413) 262-6920 | |
| Not Available |
| Full Name | Awareness Therapy Center, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 264 N Main St Ste 1a, East Longmeadow, Massachusetts |
| Authorized Official Name and Position | Ricardo A Mujica (OWNER) |
| Authorized Official Contact | 4132626920 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Awareness Therapy Center, Llc 264 N Main St Ste 1a East Longmeadow MA 01028-1815 Ph: (413) 417-4911 | Awareness Therapy Center, Llc 264 N Main St Ste 1a East Longmeadow MA 01028-1815 Ph: (413) 262-6920 |
| NPI Number | 1649798000 |
|---|---|
| Provider Enumeration Date | 09/06/2017 |
| Last Update Date | 01/12/2019 |
| Medicare PECOS PAC ID | 2466799564 |
|---|---|
| Medicare Enrollment ID | O20190128002778 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649798000 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084B0040X | Psychiatry & Neurology - Behavioral Neurology & Neuropsychiatry | 216641 (Massachusetts) | Primary |
| Provider Name | Ricardo Mujica |
|---|---|
| Provider Type | Practitioner - Geriatric Psychiatry |
| Provider Identifiers | NPI Number: 1356359152 PECOS PAC ID: 9335117423 Enrollment ID: I20040916001199 |
| Provider Name | Olga J Figueroa |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1659416451 PECOS PAC ID: 1456638378 Enrollment ID: I20170502002494 |
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