| Beautifully Unbroken Counseling Llc | |
|
20 Agard Rd Brimfield MA 01010-9760 | |
| (860) 362-0770 | |
| Not Available |
| Full Name | Beautifully Unbroken Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 20 Agard Rd, Brimfield, Massachusetts |
| Authorized Official Name and Position | Erin N Sheridan (THERAPIST) |
| Authorized Official Contact | 8603620770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beautifully Unbroken Counseling Llc 1 Main St # 120 Brimfield MA 01010-9800 Ph: (860) 362-0770 | Beautifully Unbroken Counseling Llc 20 Agard Rd Brimfield MA 01010-9760 Ph: (860) 362-0770 |
| NPI Number | 1528739455 |
|---|---|
| Provider Enumeration Date | 09/21/2021 |
| Last Update Date | 04/22/2024 |
| Certification Date | 04/22/2024 |
| Medicare PECOS PAC ID | 8123469376 |
|---|---|
| Medicare Enrollment ID | O20240518000108 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528739455 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Erin Sheridan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568719086 PECOS PAC ID: 9032550280 Enrollment ID: I20240518000115 |
Restore Psychological Services, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 12 St Clair Rd, Brimfield, MA 01010 Phone: 413-245-1487 Fax: 413-895-6589 |