Healthcare Provider Details

I. General information

NPI: 1316823933
Provider Name (Legal Business Name): CAMBRIDGE INSTITUTE FOR PSYCHOTHERAPY SERVICES AND EDUCATION, CIPSE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2025
Last Update Date: 08/31/2025
Certification Date: 08/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 HILLIARD ST OFC 103
CAMBRIDGE MA
02138-4972
US

IV. Provider business mailing address

4 EMERSON ST UNIT 1
SOMERVILLE MA
02143-3317
US

V. Phone/Fax

Practice location:
  • Phone: 773-704-1005
  • Fax:
Mailing address:
  • Phone: 773-704-1005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. KEREN PORAT
Title or Position: OWNER
Credential: PSY.D.
Phone: 773-704-1005