Provider Demographics
NPI:1235280389
Name:O'CALLAGHAN, CLARE (RNCS, EDD)
Entity Type:Individual
Prefix:
First Name:CLARE
Middle Name:
Last Name:O'CALLAGHAN
Suffix:
Gender:F
Credentials:RNCS, EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 OLD QUARRY DR
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02188-3867
Mailing Address - Country:US
Mailing Address - Phone:781-337-2118
Mailing Address - Fax:
Practice Address - Street 1:1601 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-1951
Practice Address - Country:US
Practice Address - Phone:617-425-2000
Practice Address - Fax:617-425-2043
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2024103G00000X
MA121276163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Not Answered163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
R43890Medicare UPIN