Provider Demographics
NPI:1619026762
Name:ORNE, DOUGLAS MATTHEW (PSYD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:MATTHEW
Last Name:ORNE
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 HANCOCK ST
Mailing Address - Street 2:UNIT # 9
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02170-1943
Mailing Address - Country:US
Mailing Address - Phone:617-921-6038
Mailing Address - Fax:
Practice Address - Street 1:1 CLARKS HL
Practice Address - Street 2:SUITE 305
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-8172
Practice Address - Country:US
Practice Address - Phone:508-628-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8215103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist