Provider Demographics
NPI:1588075956
Name:SPECIAL EDUCATION CONSULTANTS OF MA, LLC
Entity type:Organization
Organization Name:SPECIAL EDUCATION CONSULTANTS OF MA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:PREVELIGE
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:508-478-0126
Mailing Address - Street 1:208 MAIN ST
Mailing Address - Street 2:SUITE 115
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-2502
Mailing Address - Country:US
Mailing Address - Phone:508-478-0126
Mailing Address - Fax:
Practice Address - Street 1:208 MAIN ST
Practice Address - Street 2:SUITE 115
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-2502
Practice Address - Country:US
Practice Address - Phone:508-478-0126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-19
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA403756103TS0200X
MA10318331041C0700X
MA1018103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty