Provider Demographics
NPI:1093842544
Name:THE PSYCHOLOGICAL CENTER
Entity Type:Organization
Organization Name:THE PSYCHOLOGICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:D
Authorized Official - Last Name:FUCHU
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:978-685-1337
Mailing Address - Street 1:11 UNION ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01840-1815
Mailing Address - Country:US
Mailing Address - Phone:978-685-1333
Mailing Address - Fax:978-681-1281
Practice Address - Street 1:11 UNION ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1815
Practice Address - Country:US
Practice Address - Phone:978-685-1333
Practice Address - Fax:978-681-1281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization