| NPI | 1407524465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN E. GOLDBERG Founder 617-576-0852 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2021-09-02 |
| Last Update Date | 2021-09-02 |