Healthcare Provider Details

I. General information

NPI: 1043751126
Provider Name (Legal Business Name): DOROTHY ANNE TORMEY PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2017
Last Update Date: 03/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 N MAIN ST
LEEDS MA
01053-9764
US

IV. Provider business mailing address

421 N MAIN ST
LEEDS MA
01053-9764
US

V. Phone/Fax

Practice location:
  • Phone: 413-584-4040
  • Fax:
Mailing address:
  • Phone: 413-584-4040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number10504
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number10504
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number10504
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number10504
License Number StateMA
# 5
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number10504
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: