Provider Demographics
NPI:1740268580
Name:PSYCHOTHERAPY ASSOCIATES OF WORCESTER INC
Entity type:Organization
Organization Name:PSYCHOTHERAPY ASSOCIATES OF WORCESTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDNET
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:OWEN
Authorized Official - Last Name:CUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-757-2233
Mailing Address - Street 1:55 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-4101
Mailing Address - Country:US
Mailing Address - Phone:508-757-2233
Mailing Address - Fax:508-756-3870
Practice Address - Street 1:55 CEDAR ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-4101
Practice Address - Country:US
Practice Address - Phone:508-757-2233
Practice Address - Fax:508-756-3870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA349432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty