Provider Demographics
NPI:1679366512
Name:MCPHERSON, DIMITRI MICHAEL
Entity type:Individual
Prefix:MR
First Name:DIMITRI
Middle Name:MICHAEL
Last Name:MCPHERSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 ASHMORE RD
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01602-1823
Mailing Address - Country:US
Mailing Address - Phone:774-242-8874
Mailing Address - Fax:
Practice Address - Street 1:33 ASHMORE RD
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01602-1823
Practice Address - Country:US
Practice Address - Phone:774-242-8874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician