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Individual

ANDREW R TARASUK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LICSW

Contact information

Practice address
200 SPRINGS RD, BEDFORD, MA 01730-1198
(781) 687-2000
Mailing address
200 SPRINGS RD, BEDFORD, MA 01730-1198
(781) 687-2000

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
115882
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1154302586
MA
01
1609183839
VA BASED
MA
Enumeration date
09/09/2010
Last updated
02/13/2025
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