Healthcare Provider Details

I. General information

NPI: 1235933656
Provider Name (Legal Business Name): FEAREY PSYCHOLOGICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2025
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 BROADWAY STE 8
CAMBRIDGE MA
02139-1840
US

IV. Provider business mailing address

328 BROADWAY STE 8
CAMBRIDGE MA
02139-1840
US

V. Phone/Fax

Practice location:
  • Phone: 617-209-9397
  • Fax:
Mailing address:
  • Phone: 617-209-9397
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: ELIOT FEAREY
Title or Position: OWNER
Credential:
Phone: 617-209-9397