Provider Demographics
NPI:1427538388
Name:AMANDA RAUF PSYD
Entity Type:Organization
Organization Name:AMANDA RAUF PSYD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:RAUF
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:617-302-6692
Mailing Address - Street 1:PO BOX 590451
Mailing Address - Street 2:
Mailing Address - City:NEWTON CENTER
Mailing Address - State:MA
Mailing Address - Zip Code:02459-0004
Mailing Address - Country:US
Mailing Address - Phone:617-302-6692
Mailing Address - Fax:
Practice Address - Street 1:1280 CENTRE ST STE 210C
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02459-1553
Practice Address - Country:US
Practice Address - Phone:617-302-6692
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10338103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty