Provider Demographics
NPI:1669086997
Name:UNIQUE PSYCH SERVICES LLC
Entity type:Organization
Organization Name:UNIQUE PSYCH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:OGO
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-437-7740
Mailing Address - Street 1:10 MAZZEO DR STE 201F
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-3433
Mailing Address - Country:US
Mailing Address - Phone:781-437-7740
Mailing Address - Fax:781-986-4616
Practice Address - Street 1:10 MAZZEO DR STE 201F
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-3433
Practice Address - Country:US
Practice Address - Phone:617-752-8169
Practice Address - Fax:508-484-9421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-03
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty