Provider Demographics
NPI:1013419381
Name:ACTON PSYCHOLOGICAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:ACTON PSYCHOLOGICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELEANOR
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:FULTON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:508-785-5518
Mailing Address - Street 1:74 MEADOWVIEW RD
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:MA
Mailing Address - Zip Code:01450-1051
Mailing Address - Country:US
Mailing Address - Phone:508-785-5518
Mailing Address - Fax:
Practice Address - Street 1:532 GREAT RD
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-3415
Practice Address - Country:US
Practice Address - Phone:508-785-5518
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-02
Last Update Date:2018-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7814103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty