Provider Demographics
NPI:1164845988
Name:THE PSYCHOLOGICAL COLLABORATIVE, LLC
Entity Type:Organization
Organization Name:THE PSYCHOLOGICAL COLLABORATIVE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:781-248-8608
Mailing Address - Street 1:162 PARK ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NORTH READING
Mailing Address - State:MA
Mailing Address - Zip Code:01864-2346
Mailing Address - Country:US
Mailing Address - Phone:781-248-8608
Mailing Address - Fax:
Practice Address - Street 1:162 PARK ST
Practice Address - Street 2:SUITE 202
Practice Address - City:NORTH READING
Practice Address - State:MA
Practice Address - Zip Code:01864-2346
Practice Address - Country:US
Practice Address - Phone:781-248-8608
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-30
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8744103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty