Healthcare Provider Details

I. General information

NPI: 1215295597
Provider Name (Legal Business Name): ABELARD PSYCHOTHERAPY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2012
Last Update Date: 01/12/2021
Certification Date: 01/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 PEARL ST SUITE 3
STOUGHTON MA
02072-1610
US

IV. Provider business mailing address

450 PEARL ST SUITE 3
STOUGHTON MA
02072-1610
US

V. Phone/Fax

Practice location:
  • Phone: 781-344-0057
  • Fax: 781-344-0027
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number231520
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License Number231520
License Number StateMA

VIII. Authorized Official

Name: GABRIELLE P ABELARD
Title or Position: PRESIDENT
Credential:
Phone: 617-721-1153