Organization
BEACON OF HOPE THERAPY AND CONSULTATION SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA NAGLE-PACKARD LICSW (OWNER)
(508) 769-2117
Entity
Organization
Contact information
Practice address
21 BALL ST, WORCESTER, MA 01603-3116
(508) 769-2117
Mailing address
21 BALL ST, WORCESTER, MA 01603-3116
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120511
SOCIAL WORK LICENSE
MA
Enumeration date
04/21/2021
Last updated
04/21/2021
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