Provider Demographics
NPI:1104851708
Name:NASS, ERIC (PHD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:NASS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 LEONARD ST STE 7
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-2508
Mailing Address - Country:US
Mailing Address - Phone:781-223-1982
Mailing Address - Fax:617-643-8121
Practice Address - Street 1:83 LEONARD ST STE 7
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-2508
Practice Address - Country:US
Practice Address - Phone:781-223-1982
Practice Address - Fax:617-643-8121
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6326103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW05042OtherBLUE CROSS BLUE SHIELD
MA270737OtherMAGELLAN BEHAV. HEALTH
MA270737OtherMAGELLAN BEHAV. HEALTH