Individual
DR. THADDEUS RONALD MOGILNICKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.D.
Contact information
Practice address
323 COURT ST, PLYMOUTH, MA 02360-4322
(508) 747-2718
(508) 747-5209
Mailing address
12 SHAWME RD, SANDWICH, MA 02563-2336
(508) 888-4721
(508) 747-5209
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
912
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000030825
BOSTON MEDICAL HEALTH NET
MA
05
—
1895532
—
MA
01
—
213380
NEIGHBORHOOD HEALTH GROUP
MA
01
—
2168630
CIGNA GROUP
MA
01
—
311299
MHN
MA
01
—
468604
TUFTS
MA
01
—
497004
VAUE OPTIONS
MA
01
—
M19000
BC BS HMO GROUP
MA
01
—
W01662
BC BS INDEMNITY
MA
Enumeration date
11/06/2006
Last updated
07/08/2007
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