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NPI Code Detail

MEDICARE: NEUROBEHAVIORAL ASSOCIATES INC

MEDICARE: NEUROBEHAVIORAL ASSOCIATES INC
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
1103G00000XClinical Neuropsychologist
2103TC0700XClinical Psychologist
31041C0700XClinical Social Worker
4364S00000XClinical Nurse Specialist
52084P0800XPsychiatry Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CP0040OTHERMABCBS CNS
2M16632OTHERMABCBS MD
3W10388OTHERMABCBS PHD
4P10200OTHERMABCBS LICSW

General Provider Information

NPI Number : 1831146869
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEUROBEHAVIORAL ASSOCIATES INC
Provider Business Mailing Address
First Line : 169 LIBBEY PKWY
Second Line : 2ND FL
City : WEYMOUTH
State : MA
Zip : 02189-3101
Country : US
Telephone Number : 781-682-1060
Fax Number : 781-682-1061
Provider Business Practice Location Address
First Line : 169 LIBBEY PKWY
Second Line : 2ND FL
City : WEYMOUTH
State : MA
Zip : 02189-3101
Country : US
Telephone Number : 781-682-1060
Fax Number : 781-682-1061
Authorized Official
Title or Position : PRESIDENT
Name : DR. CHARLES R MORIN
Credential : MD
Telephone Number : 781-682-1060
Provider Enumeration Date : 05/27/2006
Last Update Date : 09/11/2025

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1609852425 — DR. ROBERT GENNARO BRANCALE M.D.
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1528032844 — DR. DAVID GAM WONG
Practice Location Address:
163 LIBBEY PKWY , #301
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02189-3101
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1023072287 — DR. MEKHALA STEPHEN M.D.
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Practice Fax: 781-335-0429
1891753885 — MS. LANA L. YANEY CRNA
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1770530388 — SOUTH SHORE ANESTHESIA ASSOCIATES, INC.
Practice Location Address:
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02189-3101
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Practice Fax: 781-335-0429

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