=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972859148
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RUBEN A HOPWOOD PHD, LP
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/25/2012
-----------------------------------------------------
Last Update Date | 03/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2 EARHART ST # 724
-----------------------------------------------------
City | CAMBRIDGE
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02141-1940
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 617-945-8749
-----------------------------------------------------
Fax | 617-849-5584
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 303 CAMBRIDGE ST # 410039
-----------------------------------------------------
City | CAMBRIDGE
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02141-1207
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 617-945-8749
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number | 6971
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 103TC1900X
-----------------------------------------------------
Taxonomy Name | Counseling Psychologist
-----------------------------------------------------
License Number | 4201
-----------------------------------------------------
License Number State | NH
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 103TH0100X
-----------------------------------------------------
Taxonomy Name | Health Service Psychologist
-----------------------------------------------------
License Number | 10733
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------