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NPI Code Detail

MEDICARE: DR. NATHANIEL CODY THORN PSY.D

MEDICARE: DR. NATHANIEL CODY THORN PSY.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
1103T00000XPsychologist9840MA
2103TC0700XClinical Psychologist9840MA

General Provider Information

NPI Number : 1730520602
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NATHANIEL CODY THORN PSY.D
Provider Business Mailing Address
First Line : 119 HOPE ST
Second Line :
City : GREENFIELD
State : MA
Zip : 01301-3516
Country : US
Telephone Number : 413-824-0476
Fax Number :
Provider Business Practice Location Address
First Line : 401 MAIN ST STE 114
Second Line :
City : AMHERST
State : MA
Zip : 01002-2353
Country : US
Telephone Number : 413-329-6117
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2013
Last Update Date : 03/29/2023

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