Healthcare Provider Details

I. General information

NPI: 1295647220
Provider Name (Legal Business Name): ELIZABETH CHEYNE, PSYD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 CENTRAL ST
WEST BOYLSTON MA
01583-1632
US

IV. Provider business mailing address

PO BOX 14
WEST BOYLSTON MA
01583-0014
US

V. Phone/Fax

Practice location:
  • Phone: 508-654-1249
  • Fax:
Mailing address:
  • Phone: 508-654-1249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH CHEYNE MELQUIST
Title or Position: OWNER
Credential: PSYD
Phone: 508-654-1249