Provider Demographics
NPI:1790298719
Name:NORTHAMPTON INSTITUTE OF INTERSUBJECTIVE PSYCHOTHERAPY
Entity Type:Organization
Organization Name:NORTHAMPTON INSTITUTE OF INTERSUBJECTIVE PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:TEW
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:413-341-1455
Mailing Address - Street 1:16 CENTER ST STE 428
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3078
Mailing Address - Country:US
Mailing Address - Phone:413-341-1455
Mailing Address - Fax:
Practice Address - Street 1:16 CENTER ST STE 428
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3078
Practice Address - Country:US
Practice Address - Phone:413-341-1455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-13
Last Update Date:2017-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA119380251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health