Healthcare Provider Details

I. General information

NPI: 1790891422
Provider Name (Legal Business Name): FRAMINGHAM PSYCHIATRIC COUNSELING ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 11/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 FOUNTAIN ST STE 402
FRAMINGHAM MA
01702-6279
US

IV. Provider business mailing address

63 FOUNTAIN ST STE 402
FRAMINGHAM MA
01702-6279
US

V. Phone/Fax

Practice location:
  • Phone: 508-872-4813
  • Fax: 508-626-0454
Mailing address:
  • Phone: 508-872-4813
  • Fax: 508-626-0454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: LISA LALIBERTE
Title or Position: PRACTICE MANAGER
Credential:
Phone: 508-872-4813