| Pediatric Behavioral Health, Llc | |
|
148 Worcester St West Boylston MA 01583-1751 | |
| (508) 835-1735 | |
| (508) 835-1736 |
| Full Name | Pediatric Behavioral Health, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 148 Worcester St, West Boylston, Massachusetts |
| Authorized Official Name and Position | Tracey Guertin (CLINICAL DIRECTOR) |
| Authorized Official Contact | 5088351735 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Behavioral Health, Llc 148 Worcester St West Boylston MA 01583-1751 Ph: (508) 835-1735 | Pediatric Behavioral Health, Llc 148 Worcester St West Boylston MA 01583-1751 Ph: (508) 835-1735 |
| NPI Number | 1487779104 |
|---|---|
| Provider Enumeration Date | 03/20/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0042677023 |
|---|---|
| Medicare Enrollment ID | O20230607000068 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487779104 | NPI | - | NPPES |
| Provider Name | Kimberly A Mastis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285791780 PECOS PAC ID: 9931248655 Enrollment ID: I20091209000190 |
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