Provider Demographics
NPI:1760889844
Name:WORCESTER CENTER FOR EXPRESSIVE THERAPIES
Entity Type:Organization
Organization Name:WORCESTER CENTER FOR EXPRESSIVE THERAPIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:C
Authorized Official - Last Name:DALY
Authorized Official - Suffix:
Authorized Official - Credentials:MT-BC, LMHC
Authorized Official - Phone:774-243-7992
Mailing Address - Street 1:255 PARK AVE STE 412
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-1953
Mailing Address - Country:US
Mailing Address - Phone:774-243-7992
Mailing Address - Fax:774-243-7993
Practice Address - Street 1:255 PARK AVE STE 304
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-1991
Practice Address - Country:US
Practice Address - Phone:774-243-7992
Practice Address - Fax:774-243-7993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-04
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8865174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty