Healthcare Provider Details

I. General information

NPI: 1568896892
Provider Name (Legal Business Name): ERIC LIND PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2013
Last Update Date: 08/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 BEACON ST SUITE 120
BROOKLINE MA
02446-4816
US

IV. Provider business mailing address

1415 BEACON ST SUITE 120
BROOKLINE MA
02446-4816
US

V. Phone/Fax

Practice location:
  • Phone: 617-566-2200
  • Fax: 617-383-6210
Mailing address:
  • Phone: 617-566-2200
  • Fax: 617-383-6210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: