Healthcare Provider Details

I. General information

NPI: 1013847151
Provider Name (Legal Business Name): IODICE PSYCHOLOGICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 MASSACHUSETTS AVE STE 4
CAMBRIDGE MA
02140-2100
US

IV. Provider business mailing address

2000 MASSACHUSETTS AVE STE 4
CAMBRIDGE MA
02140-2100
US

V. Phone/Fax

Practice location:
  • Phone: 774-836-0761
  • Fax:
Mailing address:
  • Phone: 774-836-0761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KASIE IODICE
Title or Position: LICENSED PSYCHOLOGIST/OWNER
Credential: PSYD
Phone: 774-836-0761