Organization · NPI-2

1722 Behavior & Counseling

Counselor, Mental Health · Worcester, MA

NPI number1346978491
StatusActive
Last updated in NPPESSep 11, 2025

Details

NPI
1346978491
Entity type
Organization (NPI-2)
Legal business name
1722 Behavior & Counseling
Organization subpart
No
Enumeration date
Aug 8, 2022
Certification date
Aug 15, 2022
Last updated
Sep 11, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YM0800X Counselor, Mental Health––Yes

Practice location

7 Hazelwood Rd
Worcester, MA 01609-1550

Phone 774-570-0431

Mailing address

7 Hazelwood Rd
Worcester, MA 01609-1550

Phone 774-570-0431

Authorized official

Daryle Joel Roberts
Chief Operating Office
7745700431

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