| Omni Psychotherapy Associates Llc | |
|
20 Crosby Rd Centerville MA 02632-2570 | |
| (508) 492-8648 | |
| (508) 433-1871 |
| Full Name | Omni Psychotherapy Associates Llc |
|---|---|
| Speciality | Social Worker |
| Location | 20 Crosby Rd, Centerville, Massachusetts |
| Authorized Official Name and Position | Leslie Baker (OWNER) |
| Authorized Official Contact | 5084928648 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Omni Psychotherapy Associates Llc 20 Crosby Rd Centerville MA 02632-2570 Ph: (508) 492-8648 | Omni Psychotherapy Associates Llc 20 Crosby Rd Centerville MA 02632-2570 Ph: (508) 492-8648 |
| NPI Number | 1558908830 |
|---|---|
| Provider Enumeration Date | 12/05/2019 |
| Last Update Date | 10/02/2024 |
| Certification Date | 10/02/2024 |
| Medicare PECOS PAC ID | 0840625885 |
|---|---|
| Medicare Enrollment ID | O20200121001096 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558908830 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Leslie Ann Baker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164742045 PECOS PAC ID: 9032433727 Enrollment ID: I20150129001211 |
| Provider Name | Kelsey Gray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598894529 PECOS PAC ID: 0446566269 Enrollment ID: I20150825002865 |
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