Provider Demographics
NPI:1578674032
Name:BEHAVIORAL PSYCHIATRIC & PSYCHOLOGICAL ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:BEHAVIORAL PSYCHIATRIC & PSYCHOLOGICAL ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-880-6868
Mailing Address - Street 1:PO BOX 268
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-0268
Mailing Address - Country:US
Mailing Address - Phone:508-880-6868
Mailing Address - Fax:508-880-6848
Practice Address - Street 1:90 ROUTE 44
Practice Address - Street 2:
Practice Address - City:RAYNHAM
Practice Address - State:MA
Practice Address - Zip Code:02767-1433
Practice Address - Country:US
Practice Address - Phone:508-880-6868
Practice Address - Fax:508-880-6848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA35104101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2031027Medicare ID - Type Unspecified
MAN51612Medicare ID - Type Unspecified