Provider Demographics
NPI:1235574773
Name:COUNSELING AND ASSESSMENT CLINIC OF WORCESTER
Entity Type:Organization
Organization Name:COUNSELING AND ASSESSMENT CLINIC OF WORCESTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:HYLTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMHC
Authorized Official - Phone:508-756-5400
Mailing Address - Street 1:129 MAPLE ST
Mailing Address - Street 2:#3
Mailing Address - City:NORTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01532-2061
Mailing Address - Country:US
Mailing Address - Phone:774-893-3078
Mailing Address - Fax:
Practice Address - Street 1:38 FRONT ST
Practice Address - Street 2:5TH FLOOR
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1732
Practice Address - Country:US
Practice Address - Phone:508-756-5400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-09
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health