Healthcare Provider Details

I. General information

NPI: 1487735486
Provider Name (Legal Business Name): PAUL KENT LOUSCHER PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 03/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 LIBBEY INDUSTRIAL PKWY 2ND FLOOR
WEYMOUTH MA
02189-3101
US

IV. Provider business mailing address

41 LINDEN ST 2ND FLOOR
BROOKLINE MA
02445-7359
US

V. Phone/Fax

Practice location:
  • Phone: 781-682-1060
  • Fax: 781-682-1061
Mailing address:
  • Phone: 617-232-0662
  • Fax: 617-232-0662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number8273
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: