Provider Demographics
NPI:1760061659
Name:CAMBRIDGE PSYCHOLOGY GROUP, INC
Entity Type:Organization
Organization Name:CAMBRIDGE PSYCHOLOGY GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:ASHLEY
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:617-977-4770
Mailing Address - Street 1:PO BOX 1285
Mailing Address - Street 2:
Mailing Address - City:EAST ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-0021
Mailing Address - Country:US
Mailing Address - Phone:617-977-4770
Mailing Address - Fax:
Practice Address - Street 1:226 MASSACHUSETTS AVE STE 2A
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-8449
Practice Address - Country:US
Practice Address - Phone:617-977-4770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-07
Last Update Date:2021-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty