Provider Demographics
NPI:1376663393
Name:BEHAVIORAL HEALTH ASSOCIATES OF CENTRAL MASSACHUSETTS
Entity Type:Organization
Organization Name:BEHAVIORAL HEALTH ASSOCIATES OF CENTRAL MASSACHUSETTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:NOWAK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:508-752-7332
Mailing Address - Street 1:30 SEVER ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-2194
Mailing Address - Country:US
Mailing Address - Phone:508-752-7332
Mailing Address - Fax:508-753-2551
Practice Address - Street 1:30 SEVER ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-2194
Practice Address - Country:US
Practice Address - Phone:508-752-7332
Practice Address - Fax:508-753-2551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9775382Medicaid
MA9775382Medicaid