Provider Demographics
NPI:1508070947
Name:KIRBY, MICHAELA (PSYD, ATR-BC)
Entity Type:Individual
Prefix:DR
First Name:MICHAELA
Middle Name:
Last Name:KIRBY
Suffix:
Gender:F
Credentials:PSYD, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 CENTRAL ST STE 205
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-4816
Mailing Address - Country:US
Mailing Address - Phone:617-901-0786
Mailing Address - Fax:
Practice Address - Street 1:7 CENTRAL ST STE 205
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-4816
Practice Address - Country:US
Practice Address - Phone:617-901-0786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA426101YM0800X
MA8513103T00000X, 103TM1800X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities