Provider Demographics
NPI:1689617680
Name:PINSKY, HARVEY (PHD)
Entity Type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:
Last Name:PINSKY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:359 BERLIN RD
Mailing Address - Street 2:
Mailing Address - City:BOLTON
Mailing Address - State:MA
Mailing Address - Zip Code:01740-1320
Mailing Address - Country:US
Mailing Address - Phone:508-366-0551
Mailing Address - Fax:978-779-2204
Practice Address - Street 1:40 MECHANIC ST
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-4425
Practice Address - Country:US
Practice Address - Phone:508-366-0551
Practice Address - Fax:978-779-2204
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2016-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPY1719PR103TC2200X, 103T00000X
MA515106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW01625Medicare ID - Type Unspecified