Healthcare Provider Details

I. General information

NPI: 1366847956
Provider Name (Legal Business Name): SEJAL MAHESH PATEL PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2014
Last Update Date: 04/12/2026
Certification Date: 04/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 MARKET ST
IPSWICH MA
01938-2264
US

IV. Provider business mailing address

42 MARKET ST
IPSWICH MA
01938-2264
US

V. Phone/Fax

Practice location:
  • Phone: 617-209-9709
  • Fax:
Mailing address:
  • Phone: 617-209-9709
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY10222
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY10222
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: