Healthcare Provider Details

I. General information

NPI: 1356552541
Provider Name (Legal Business Name): CHRISTOPHER EDWARD MORTON PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2007
Last Update Date: 11/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

799 CONCORD AVE #4
CAMBRIDGE MA
02138-1048
US

IV. Provider business mailing address

799 CONCORD AVE #4
CAMBRIDGE MA
02138-1048
US

V. Phone/Fax

Practice location:
  • Phone: 617-491-0660
  • Fax:
Mailing address:
  • Phone: 617-491-0660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number8534
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: