Healthcare Provider Details

I. General information

NPI: 1255780755
Provider Name (Legal Business Name): MARIA CABANE PSYD., M. ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2016
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 BEACONSFIELD RD
BROOKLINE MA
02445-3322
US

IV. Provider business mailing address

120 BEACONSFIELD RD
BROOKLINE MA
02445-3322
US

V. Phone/Fax

Practice location:
  • Phone: 617-959-3795
  • Fax:
Mailing address:
  • Phone: 617-959-3795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number11565-MH-CC
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: