Provider Demographics
NPI:1689079907
Name:NADIM, TAHEREH NARGES (PSYAD)
Entity Type:Individual
Prefix:DR
First Name:TAHEREH
Middle Name:NARGES
Last Name:NADIM
Suffix:
Gender:F
Credentials:PSYAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42D SHREWSBURY GREEN DR
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-3629
Mailing Address - Country:US
Mailing Address - Phone:617-780-7946
Mailing Address - Fax:
Practice Address - Street 1:63 FOUNTAIN ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-6279
Practice Address - Country:US
Practice Address - Phone:413-277-3115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-29
Last Update Date:2023-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MA5000786101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program