Provider Demographics
NPI:1346350188
Name:ARDITO FIELDS, CYNTHIA LOUISE (PSYD)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:LOUISE
Last Name:ARDITO FIELDS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:MISS
Other - First Name:CYNTHIA
Other - Middle Name:LOUISE
Other - Last Name:ARDITO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:129 ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:HOLLISTON
Mailing Address - State:MA
Mailing Address - Zip Code:01746-1469
Mailing Address - Country:US
Mailing Address - Phone:508-429-8767
Mailing Address - Fax:
Practice Address - Street 1:10 LANGLEY RD
Practice Address - Street 2:SUITE 200
Practice Address - City:NEWTON CENTRE
Practice Address - State:MA
Practice Address - Zip Code:02459
Practice Address - Country:US
Practice Address - Phone:508-429-8767
Practice Address - Fax:617-332-7863
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6674103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
W10489OtherBCBS INDEMNITY
010608OtherVALUE OPTIONS
61-00062OtherEVERCARE
W10489OtherBCBS INDEMNITY