Provider Demographics
NPI:1538330584
Name:CAMBRIDGE COUNSELING ASSOCIATES
Entity Type:Organization
Organization Name:CAMBRIDGE COUNSELING ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIRBAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-287-5557
Mailing Address - Street 1:479 WEST ST
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:MA
Mailing Address - Zip Code:01741-1439
Mailing Address - Country:US
Mailing Address - Phone:978-287-5557
Mailing Address - Fax:
Practice Address - Street 1:479 WEST ST
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:MA
Practice Address - Zip Code:01741-1439
Practice Address - Country:US
Practice Address - Phone:978-287-5557
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2873103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW10435OtherBCBS MASS