Organization
SUPPORTIVE BEHAVIORAL CARE OF MASS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAPHAEL LICHTSCHEIN (PRESIDENT)
(718) 298-4375
Entity
Organization
Contact information
Practice address
11 NORTH ST, STONEHAM, MA 02180-1040
(718) 506-1115
Mailing address
27 RANDOLPH RD, HOWELL, NJ 07731-8611
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
103TC0700X
Clinical Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
02/12/2025
Last updated
02/12/2025
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