Healthcare Provider Details

I. General information

NPI: 1649350240
Provider Name (Legal Business Name): JAMES HORVITZ PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 10/11/2022
Certification Date: 10/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 GLEN ST STE 13
STOUGHTON MA
02072-2481
US

IV. Provider business mailing address

27 GLEN ST STE 13
STOUGHTON MA
02072-2481
US

V. Phone/Fax

Practice location:
  • Phone: 781-682-1060
  • Fax: 781-682-1061
Mailing address:
  • Phone: 781-344-0998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1857
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: