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General NPI Number Information
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NPI Number | 1265732465
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Entity Type | Organization
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Legal Business Name | PSYCHOLOGICAL HEALTH CARE, INC.
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Dates
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Enumeration Date | 10/22/2010
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Last Update Date | 10/22/2010
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Provider Practice Location Address
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Address Line | 36 PLUMFIELD LN
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City | DUXBURY
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State | MA
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Zip | 02332-3823
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Country | US
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Telephone | 781-934-2597
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Fax |
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Provider Business Mailing Address
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Address Line | 36 PLUMFIELD LN
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City | DUXBURY
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State | MA
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Zip | 02332-3823
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Country | US
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Telephone | 781-934-2597
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LESLIE HART MACCARDELL
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Credential | PH.D., M.P.
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Telephone | 781-934-2597
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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