Healthcare Provider Details

I. General information

NPI: 1104065853
Provider Name (Legal Business Name): ARETE PSYCHOLOGY CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2009
Last Update Date: 02/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 MAIN ST STE 6B
CONCORD MA
01742-3058
US

IV. Provider business mailing address

1150 MAIN ST STE 6B
CONCORD MA
01742-3058
US

V. Phone/Fax

Practice location:
  • Phone: 978-337-6095
  • Fax:
Mailing address:
  • Phone: 978-337-6095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number6775
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code103TE1100X
TaxonomyExercise & Sports Psychologist
License Number6775
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6775
License Number StateMA

VIII. Authorized Official

Name: DR. SHARON A. CHIRBAN
Title or Position: DIRECTOR
Credential: PH.D.
Phone: 978-337-6095