Provider Demographics
NPI:1588956148
Name:THERAPY ASSOCIATES OF CHELMSFORD,LLC
Entity type:Organization
Organization Name:THERAPY ASSOCIATES OF CHELMSFORD,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LUCILLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:RADCLIFFE
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:978-726-5805
Mailing Address - Street 1:3 COURTHOUSE LN UNIT 8
Mailing Address - Street 2:
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-1720
Mailing Address - Country:US
Mailing Address - Phone:978-726-5805
Mailing Address - Fax:
Practice Address - Street 1:3 COURTHOUSE LN UNIT 8
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-1720
Practice Address - Country:US
Practice Address - Phone:978-726-5805
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-13
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1114771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty