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General NPI Number Information
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NPI Number | 1992025506
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Entity Type | Organization
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Legal Business Name | ASCENDANT PSYCHIATRIC & CONSULTING CENTRE
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Dates
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Enumeration Date | 06/04/2010
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Last Update Date | 07/30/2012
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Provider Practice Location Address
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Address Line | 175 DERBY ST STE 21-22
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City | HINGHAM
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State | MA
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Zip | 02043-4007
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Country | US
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Telephone | 781-556-5662
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Fax | 781-836-0676
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Provider Business Mailing Address
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Address Line | 175 DERBY ST STE 21-22
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City | HINGHAM
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State | MA
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Zip | 02043-4007
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Country | US
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Telephone | 781-556-5662
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Fax | 781-836-0676
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Authorized Official
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Title or Position | CEO
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Name | DR. LINDA M CARMODY-KACZOR
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Credential | PHD
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Telephone | 781-556-5662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 6175
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6175
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License Number State | MA
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