Provider Demographics
NPI:1710010277
Name:PSYCHOLOGICAL ASSOCIATES
Entity Type:Organization
Organization Name:PSYCHOLOGICAL ASSOCIATES
Other - Org Name:MARTIN COHEN DBA PSYCHOLOGICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:781-393-8889
Mailing Address - Street 1:92 HIGH ST STE DH7
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-3838
Mailing Address - Country:US
Mailing Address - Phone:781-393-8889
Mailing Address - Fax:781-396-3948
Practice Address - Street 1:92 HIGH ST STE DH7
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-3838
Practice Address - Country:US
Practice Address - Phone:781-393-8889
Practice Address - Fax:781-396-3948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty