Provider Demographics
NPI:1225484181
Name:MASSACHUSETTS MULTICULTURAL PSYCHO-EDUCATIONAL ASSESSMENT CENTER
Entity Type:Organization
Organization Name:MASSACHUSETTS MULTICULTURAL PSYCHO-EDUCATIONAL ASSESSMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMHC
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RACHMACIEJ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-281-8035
Mailing Address - Street 1:1 KING ST
Mailing Address - Street 2:UNIT 3
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02122-1118
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 KING ST
Practice Address - Street 2:UNIT 3
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02122-1118
Practice Address - Country:US
Practice Address - Phone:413-281-8035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-10
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9585101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9585OtherLICENSE NUMBER