Healthcare Provider Details

I. General information

NPI: 1780878678
Provider Name (Legal Business Name): BOND & BERK ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2007
Last Update Date: 09/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

236 GLEN RD
WESTON MA
02493-2237
US

IV. Provider business mailing address

236 GLEN RD
WESTON MA
02493-2237
US

V. Phone/Fax

Practice location:
  • Phone: 781-431-7792
  • Fax: 781-431-9622
Mailing address:
  • Phone: 781-431-7792
  • Fax: 781-431-9622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3039
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number102238
License Number StateMA

VIII. Authorized Official

Name: DR. STEVEN ALAN BERK
Title or Position: DIRECTOR
Credential: PH.D.
Phone: 781-431-7792