Provider Demographics
NPI:1326359753
Name:MUIRURI, SERAH W (MED, CRC)
Entity Type:Individual
Prefix:MS
First Name:SERAH
Middle Name:W
Last Name:MUIRURI
Suffix:
Gender:F
Credentials:MED, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 SMITH RD
Mailing Address - Street 2:
Mailing Address - City:SUTTON
Mailing Address - State:MA
Mailing Address - Zip Code:01590-3723
Mailing Address - Country:US
Mailing Address - Phone:508-865-6216
Mailing Address - Fax:
Practice Address - Street 1:81 HOPE AVE
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01603-2212
Practice Address - Country:US
Practice Address - Phone:508-755-2340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA001Medicaid
002002Medicare Oscar/Certification
MA001Medicaid
005Medicare UPIN
MA0011223344Medicare NSC
003Medicare PIN