Provider Demographics
NPI:1710439617
Name:ACHIEVE NEW ENGLAND, LLC
Entity Type:Organization
Organization Name:ACHIEVE NEW ENGLAND, LLC
Other - Org Name:NEUROPSYCHOLOGICAL ASSESSMENT AND CONSULTING SERVICES LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST & CO-DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:DOTY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:617-539-6762
Mailing Address - Street 1:801 MAIN ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-3313
Mailing Address - Country:US
Mailing Address - Phone:617-539-6762
Mailing Address - Fax:617-275-4071
Practice Address - Street 1:801 MAIN ST
Practice Address - Street 2:SUITE 7
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-3313
Practice Address - Country:US
Practice Address - Phone:617-539-6762
Practice Address - Fax:617-275-4071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-26
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPY9369103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty