Provider Demographics
NPI:1598946329
Name:MCHUGH, REBECCA KATHRYN (PHD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:KATHRYN
Last Name:MCHUGH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 MILL ST
Mailing Address - Street 2:MS222
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-1064
Mailing Address - Country:US
Mailing Address - Phone:617-855-3169
Mailing Address - Fax:617-855-2699
Practice Address - Street 1:115 MILL ST
Practice Address - Street 2:MS222
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-1064
Practice Address - Country:US
Practice Address - Phone:617-855-3169
Practice Address - Fax:617-855-2699
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-20
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MA249304103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program