Healthcare Provider Details

I. General information

NPI: 1194934026
Provider Name (Legal Business Name): CENTRAL SQUARE THERAPY ASSOCIATES L.L.P.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 MARKET ST 2ND FLOOR
LYNN MA
01901-1529
US

IV. Provider business mailing address

150 MARKET ST 2ND FLOOR
LYNN MA
01901-1529
US

V. Phone/Fax

Practice location:
  • Phone: 781-592-6100
  • Fax: 781-592-1093
Mailing address:
  • Phone: 781-592-6100
  • Fax: 781-592-1093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number StateMA

VIII. Authorized Official

Name: MR. ROBERT A PAGE
Title or Position: MANAGEING PARTNER
Credential: PH.D
Phone: 781-592-6100