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Individual

AMELIA FAZACKERLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MT-BC, LMHC

Contact information

Practice address
670 W BOYLSTON ST, WORCESTER, MA 01606-2092
(508) 853-2300
Mailing address
28 KING PHILIP RD APT 1, WORCESTER, MA 01606-2188
(404) 368-8528

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LMHC10002923
MA

Other

Enumeration date
11/16/2022
Last updated
08/05/2025
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