Healthcare Provider Details

I. General information

NPI: 1013039809
Provider Name (Legal Business Name): CHRISTOPHER DUANE WELCH PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 COLLEGE AVE
SOMERVILLE MA
02144-1957
US

IV. Provider business mailing address

22 MILL ST STE 4
ARLINGTON MA
02476-4738
US

V. Phone/Fax

Practice location:
  • Phone: 617-629-6628
  • Fax:
Mailing address:
  • Phone: 781-551-0999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY10053
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: