Healthcare Provider Details

I. General information

NPI: 1760290878
Provider Name (Legal Business Name): CATHARINE B N BARCLAY ED.S, LEP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2024
Last Update Date: 12/20/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 GOULD ST STE 290
NEEDHAM MA
02494-2397
US

IV. Provider business mailing address

18 WATER ST
WINCHESTER MA
01890-1531
US

V. Phone/Fax

Practice location:
  • Phone: 781-400-2605
  • Fax:
Mailing address:
  • Phone: 857-636-8382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number517720
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: