Provider Demographics
NPI:1043254824
Name:WORCESTER YOUTH AND FAMILY COUNSELING SERVICES, INC.
Entity type:Organization
Organization Name:WORCESTER YOUTH AND FAMILY COUNSELING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-641-4598
Mailing Address - Street 1:124 N MAIN ST STE C
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:MD
Mailing Address - Zip Code:21811-1062
Mailing Address - Country:US
Mailing Address - Phone:410-641-4598
Mailing Address - Fax:410-641-4696
Practice Address - Street 1:124 N MAIN ST STE C
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:MD
Practice Address - Zip Code:21811-1062
Practice Address - Country:US
Practice Address - Phone:410-641-4598
Practice Address - Fax:410-641-4696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD735579000OtherMAGELLAN
MDG934-0000OtherNCA CAREFIRST BCBS
MD415786900Medicaid
MDKK62-WOOtherMD CAREFIRST BCBS
KK62Medicare PIN