Healthcare Provider Details

I. General information

NPI: 1992128086
Provider Name (Legal Business Name): STREFF ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2014
Last Update Date: 01/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

532 GREAT RD
ACTON MA
01720-3415
US

IV. Provider business mailing address

532 GREAT RD
ACTON MA
01720-3415
US

V. Phone/Fax

Practice location:
  • Phone: 978-263-0439
  • Fax: 978-486-3140
Mailing address:
  • Phone: 978-263-0439
  • Fax: 978-486-3140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2084
License Number StateMA

VIII. Authorized Official

Name: DR. CHARLES EDWARD STREFF
Title or Position: CO-DIRECTOR
Credential: PH.D.
Phone: 978-263-0439