Provider Demographics
NPI:1841820313
Name:ON WATCH COUNSELING SERVICES
Entity type:Organization
Organization Name:ON WATCH COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERPIST/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:PAVONE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:508-745-3404
Mailing Address - Street 1:316 PLANTATION ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-1745
Mailing Address - Country:US
Mailing Address - Phone:508-745-3404
Mailing Address - Fax:508-796-1650
Practice Address - Street 1:316 PLANTATION ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-1745
Practice Address - Country:US
Practice Address - Phone:508-745-3404
Practice Address - Fax:508-796-1650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-23
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health