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Organization
STACEY J RUTHERFORD, LICSW P.C.
Active
Organization
STACEY J RUTHERFORD, LICSW P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY JENEE RUTHERFORD LICSW, MSW (PRESIDENT)
(508) 438-0110
Entity
Organization
Contact information
Practice address
198 RUSSELL ST, WORCESTER, MA 01609-2200
(508) 438-0110
Mailing address
198 RUSSELL ST, WORCESTER, MA 01609-2200
(508) 438-0110
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
110648
MA
Other
Enumeration date
01/03/2007
Last updated
08/22/2020
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