MEDICARE: DR. LYNDA MORRIS PARHAM PH.D.

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	103TC0700X	Clinical Psychologist	8235	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8235	OTHER	MA	LICDPSYCHOLOGIST PROVIDER

General Provider Information

NPI Number	:	1588764757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LYNDA MORRIS PARHAM PH.D.

Provider Business Mailing Address
First Line	:	503 PLANO DR
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27703-7816
Country	:	US
Telephone Number	:	617-364-8888
Fax Number	:	509-463-6385

Provider Business Practice Location Address
First Line	:	1330 BEACON ST
Second Line	:	STE 327
City	:	BROOKLINE
State	:	MA
Zip	:	02446-3203
Country	:	US
Telephone Number	:	617-358-1804
Fax Number	:

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

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	01/13/2017

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