Provider Demographics
NPI:1164574257
Name:MCLAUGHLIN, EDWARD F (PHD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:F
Last Name:MCLAUGHLIN
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 1:59 TEMPLE PL
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-1307
Mailing Address - Country:US
Mailing Address - Phone:617-357-5738
Mailing Address - Fax:617-357-5646
Practice Address - Street 1:59 TEMPLE PL
Practice Address - Street 2:SUITE 400
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1307
Practice Address - Country:US
Practice Address - Phone:617-357-5738
Practice Address - Fax:617-357-5646
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3518103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAMC W03540Medicare ID - Type Unspecified