Individual
MARY BOBOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
191 MAY ST, WORCESTER, MA 01602
(508) 368-7888
(508) 792-4392
Mailing address
630 PLANTATION ST, WORCESTER, MA 01605
(508) 368-7888
(508) 792-4392
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1026597
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04247226
ONE HEALTH PLAN
—
01
—
042472266
PRIVATE HEALTHCARE SYSTEM
—
01
—
042472266006
TRICARE CHAMPUS
—
01
—
1061933
CIGNA HEALTH PLAN
—
01
—
2043637
FIRST HEALTH
—
01
—
33824
FALLON COMMUNITY HEALTH P
—
01
—
580244000
MAGELLAN BEHAVIORAL HEALT
—
01
—
785946
MVP HEALTH CARE
—
01
—
800011108
RAILROAD MEDICARE
—
01
—
P07209
BLUE SHIELD HMO BLUE
—
01
—
P20253
MEDICARE B
—
Enumeration date
01/30/2006
Last updated
01/30/2009
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