Healthcare Provider Details

I. General information

NPI: 1184470445
Provider Name (Legal Business Name): PRACTICAL NEUROPSYCHIATRY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2024
Last Update Date: 09/06/2025
Certification Date: 09/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 KNOLLWOOD DR
WORCESTER MA
01609-1203
US

IV. Provider business mailing address

1 KNOLLWOOD DR
WORCESTER MA
01609-1203
US

V. Phone/Fax

Practice location:
  • Phone: 508-815-7284
  • Fax: 314-784-9836
Mailing address:
  • Phone: 508-815-7284
  • Fax: 314-784-9836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JOSHUA D CLAUNCH
Title or Position: OWNER, PHYSICIAN
Credential: MD
Phone: 508-815-7284