Provider Demographics
NPI:1245415520
Name:FAMILY WORKS PSYCHOLOGICAL AND ASSESSMENT SERVICES, LLC
Entity Type:Organization
Organization Name:FAMILY WORKS PSYCHOLOGICAL AND ASSESSMENT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:ANDREA
Authorized Official - Last Name:WAHBA
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC, PSYD
Authorized Official - Phone:508-791-9340
Mailing Address - Street 1:51 UNION ST
Mailing Address - Street 2:SUITE 216
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1194
Mailing Address - Country:US
Mailing Address - Phone:508-791-9340
Mailing Address - Fax:508-791-9345
Practice Address - Street 1:51 UNION ST
Practice Address - Street 2:SUITE 216
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1194
Practice Address - Country:US
Practice Address - Phone:508-791-9340
Practice Address - Fax:508-791-9345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-04
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8302251S00000X
MA5545251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health