Healthcare Provider Details

I. General information

NPI: 1528999042
Provider Name (Legal Business Name): BEACON HILL BEHAVIORAL HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 STRATFORD RD
NEEDHAM MA
02492-1433
US

IV. Provider business mailing address

230 STRATFORD RD
NEEDHAM MA
02492-1433
US

V. Phone/Fax

Practice location:
  • Phone: 781-455-0576
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: ROBERT MARON
Title or Position: OWNER
Credential:
Phone: 781-455-0576