Healthcare Provider Details

I. General information

NPI: 1952228652
Provider Name (Legal Business Name): JASON PUGATCH PSYCHOTHERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

49 HANCOCK ST STE 209
CAMBRIDGE MA
02139-3188
US

IV. Provider business mailing address

49 HANCOCK ST STE 209
CAMBRIDGE MA
02139-3188
US

V. Phone/Fax

Practice location:
  • Phone: 781-222-4304
  • Fax:
Mailing address:
  • Phone: 781-222-4304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JASON PUGATCH
Title or Position: MANAGING MEMBER
Credential: LICSW
Phone: 781-222-4304