Provider Demographics
NPI:1558463067
Name:PSYCHOTHERAPY ASSOCIATES OF NORTH READING
Entity Type:Organization
Organization Name:PSYCHOTHERAPY ASSOCIATES OF NORTH READING
Other - Org Name:PANR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER/GENERAL PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:THOMFORDE
Authorized Official - Last Name:KAUFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:978-664-2566
Mailing Address - Street 1:324 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORTH READING
Mailing Address - State:MA
Mailing Address - Zip Code:01864-1329
Mailing Address - Country:US
Mailing Address - Phone:978-664-2566
Mailing Address - Fax:978-664-8023
Practice Address - Street 1:324 MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH READING
Practice Address - State:MA
Practice Address - Zip Code:01864-1329
Practice Address - Country:US
Practice Address - Phone:978-664-2566
Practice Address - Fax:978-664-8023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP10163OtherBC/BS
MA42730OtherMAGELLAN BEHAV. HEALTH
MAA000960OtherVALUE OPTIONS
MA1011720OtherBEACON HEALTH STRATEGIES
MA733017OtherTUFTS
MAM20840Medicare ID - Type Unspecified