Healthcare Provider Details

I. General information

NPI: 1376484535
Provider Name (Legal Business Name): ALICIA SAMBURSKY PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 PROVIDENCE HWY # 167
WALPOLE MA
02081-2553
US

IV. Provider business mailing address

1600 PROVIDENCE HWY # 167
WALPOLE MA
02081-2553
US

V. Phone/Fax

Practice location:
  • Phone: 508-660-7949
  • Fax: 508-660-7943
Mailing address:
  • Phone: 508-660-7949
  • Fax: 508-660-7943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2317958
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: