Provider Demographics
NPI:1952850463
Name:R. BUIVYDAS, PHD, LMHC, COUPLES COUNSELING & INDIVIDUAL THERAPY, PLLC
Entity Type:Organization
Organization Name:R. BUIVYDAS, PHD, LMHC, COUPLES COUNSELING & INDIVIDUAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROMAS
Authorized Official - Middle Name:D
Authorized Official - Last Name:BUIVYDAS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMHC
Authorized Official - Phone:508-281-0222
Mailing Address - Street 1:297 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-5421
Mailing Address - Country:US
Mailing Address - Phone:508-281-0222
Mailing Address - Fax:
Practice Address - Street 1:297 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-5421
Practice Address - Country:US
Practice Address - Phone:508-281-0222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-26
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4099261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health