Provider Demographics
NPI:1093338097
Name:CASARJIAN, BETHANY (PHD)
Entity Type:Individual
Prefix:DR
First Name:BETHANY
Middle Name:
Last Name:CASARJIAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 ASH ST
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:MA
Mailing Address - Zip Code:02493-1943
Mailing Address - Country:US
Mailing Address - Phone:781-894-2313
Mailing Address - Fax:
Practice Address - Street 1:73 ASH ST
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:MA
Practice Address - Zip Code:02493-1943
Practice Address - Country:US
Practice Address - Phone:781-894-2313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-26
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9137103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist