Provider Demographics
NPI:1164591210
Name:CAUST, BARBARA LORRIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:LORRIE
Last Name:CAUST
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 1:114 WALTHAM ST
Mailing Address - Street 2:SUITE 10
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-5415
Mailing Address - Country:US
Mailing Address - Phone:781-861-9722
Mailing Address - Fax:781-674-3133
Practice Address - Street 1:114 WALTHAM ST
Practice Address - Street 2:SUITE 10
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-5415
Practice Address - Country:US
Practice Address - Phone:781-861-9722
Practice Address - Fax:781-674-3133
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1789101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW01878Medicare ID - Type Unspecified