Healthcare Provider Details
I. General information
NPI: 1598838781
Provider Name (Legal Business Name): NOVA PSYCHIATRIC SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/16/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1261 FURNACE BROOK PKWY SUITE 31
QUINCY MA
02169
US
IV. Provider business mailing address
74 HOBART STREET
BRAINTREE MA
02184
US
V. Phone/Fax
- Phone: 617-479-4545
- Fax: 617-479-4555
- Phone: 781-848-2363
- Fax: 781-337-8766
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 5182 |
| License Number State | MA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | 5182 |
| License Number State | MA |
VIII. Authorized Official
Name:
ALEXANDRA
ACCORDI
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 617-479-4545