Provider Demographics
NPI:1437112927
Name:AMESBURY PSYCHOLOGICAL CENTER, INC
Entity Type:Organization
Organization Name:AMESBURY PSYCHOLOGICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:NESTOR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMHC, LMFT
Authorized Official - Phone:978-388-5700
Mailing Address - Street 1:24 MORRILL PL
Mailing Address - Street 2:
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-3530
Mailing Address - Country:US
Mailing Address - Phone:978-388-5700
Mailing Address - Fax:978-388-4052
Practice Address - Street 1:24 MORRILL PLACE
Practice Address - Street 2:
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913-3530
Practice Address - Country:US
Practice Address - Phone:978-388-5700
Practice Address - Fax:978-388-4052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-07
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1300008Medicaid
MA1300008Medicaid