Provider Demographics
NPI:1629679915
Name:NATICK COUNSELING
Entity Type:Organization
Organization Name:NATICK COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:VISHNEVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:617-752-2630
Mailing Address - Street 1:1372 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:PA
Mailing Address - Zip Code:18974-6136
Mailing Address - Country:US
Mailing Address - Phone:774-291-1978
Mailing Address - Fax:
Practice Address - Street 1:41 UNIVERSITY DRIVE
Practice Address - Street 2:SUITE 428
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940
Practice Address - Country:US
Practice Address - Phone:617-752-2630
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health