Provider Demographics
NPI:1144387531
Name:DICHIARA, CARMINE ANTHONY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CARMINE
Middle Name:ANTHONY
Last Name:DICHIARA
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 SAINT MARY ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494-3165
Mailing Address - Country:US
Mailing Address - Phone:857-523-0190
Mailing Address - Fax:
Practice Address - Street 1:221 SAINT MARY ST UNIT 2
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494-3165
Practice Address - Country:US
Practice Address - Phone:617-765-2080
Practice Address - Fax:888-622-7933
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA 9364 PSY103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical