Provider Demographics
NPI:1265501936
Name:ADFILIARE PSYCHOTHERAPY INC
Entity Type:Organization
Organization Name:ADFILIARE PSYCHOTHERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSEANNE
Authorized Official - Middle Name:C
Authorized Official - Last Name:DOLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-329-4774
Mailing Address - Street 1:980 WASHINGTON ST
Mailing Address - Street 2:SUITE 209
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026
Mailing Address - Country:US
Mailing Address - Phone:781-329-4774
Mailing Address - Fax:781-329-9153
Practice Address - Street 1:980 WASHINGTON ST
Practice Address - Street 2:SUITE 209
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026
Practice Address - Country:US
Practice Address - Phone:781-329-4774
Practice Address - Fax:781-329-9153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA105498103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM21637Medicare ID - Type Unspecified