MEDICARE: DR. JOHN EDWARD MCHALE JR. EDD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	4292	MA
2	103TC0700X	Clinical Psychologist	4292	MA

General Provider Information

NPI Number	:	1568537975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN EDWARD MCHALE JR. EDD

Provider Business Mailing Address
First Line	:	30 JOHNSON LANE
Second Line	:
City	:	WEST YARMOUTH
State	:	MA
Zip	:	02673-2753
Country	:	US
Telephone Number	:	508-394-7525
Fax Number	:

Provider Business Practice Location Address
First Line	:	1070 ROUTE 134
Second Line	:
City	:	EAST DENNIS
State	:	MA
Zip	:	02641-0000
Country	:	US
Telephone Number	:	508-394-7525
Fax Number	:	833-354-0981

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	03/31/2022

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Directions to “ DR. JOHN EDWARD MCHALE JR. EDD” Practice Location

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