Provider Demographics
NPI:1427527373
Name:INSTITUTE FOR TRAUMA AND HEALING
Entity type:Organization
Organization Name:INSTITUTE FOR TRAUMA AND HEALING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:FROHOCK
Authorized Official - Suffix:
Authorized Official - Credentials:LMHCLRC
Authorized Official - Phone:508-799-6306
Mailing Address - Street 1:51 UNION STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608
Mailing Address - Country:US
Mailing Address - Phone:508-799-6306
Mailing Address - Fax:508-799-6935
Practice Address - Street 1:51 UNION STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608
Practice Address - Country:US
Practice Address - Phone:508-799-6306
Practice Address - Fax:508-799-6935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-21
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health