Healthcare Provider Details

I. General information

NPI: 1831242981
Provider Name (Legal Business Name): DEBORAH ELLEN WEINSTOCK-SAVOY PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2007
Last Update Date: 04/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 JOHN BENSON RD
LEXINGTON MA
02420-1143
US

IV. Provider business mailing address

1 JOHN BENSON RD
LEXINGTON MA
02420-1143
US

V. Phone/Fax

Practice location:
  • Phone: 781-862-3388
  • Fax: 781-862-5559
Mailing address:
  • Phone: 781-862-3388
  • Fax: 781-862-5559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number4502
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number4502
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: