Provider Demographics
NPI:1063795292
Name:TESZ, AMY E (LMHC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:E
Last Name:TESZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-2134
Mailing Address - Country:US
Mailing Address - Phone:508-752-5191
Mailing Address - Fax:508-792-1514
Practice Address - Street 1:52 CEDAR ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-2134
Practice Address - Country:US
Practice Address - Phone:508-752-5191
Practice Address - Fax:508-792-1514
Is Sole Proprietor?:No
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5972101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health