| Odonata Psychotherapy & Retreat Center Llc | |
|
121 Main St Buzzards Bay MA 02532 | |
| (774) 247-4939 | |
| (774) 302-4419 |
| Full Name | Odonata Psychotherapy & Retreat Center Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 121 Main St, Buzzards Bay, Massachusetts |
| Authorized Official Name and Position | Nancy C Wiley (OWNER) |
| Authorized Official Contact | 7742474939 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Odonata Psychotherapy & Retreat Center Llc 121 Main St Buzzards Bay MA 02532-3245 Ph: (774) 247-4939 | Odonata Psychotherapy & Retreat Center Llc 121 Main St Buzzards Bay MA 02532 Ph: (774) 247-4939 |
| NPI Number | 1902285414 |
|---|---|
| Provider Enumeration Date | 05/29/2015 |
| Last Update Date | 08/15/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902285414 | NPI | - | NPPES |
| 110101319A | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 118383 (Massachusetts) | Primary |
Behavioral Connections Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 134 Main St, Buzzards Bay, MA 02532 Phone: 508-743-5320 | |
Southeast Clinical Collaboration Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9 Saint Margarets St, Buzzards Bay, MA 02532 Phone: 508-326-4371 | |
Odonata Psychotherapy & Retreat Center Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 121 Main St, Buzzards Bay, MA 02532 Phone: 774-247-4939 |