Provider Demographics
NPI:1821112798
Name:APPLIED PSYCHOLOGY SYSTEMS
Entity Type:Organization
Organization Name:APPLIED PSYCHOLOGY SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:SWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-971-3007
Mailing Address - Street 1:158 UPLAND RD
Mailing Address - Street 2:
Mailing Address - City:WABAN
Mailing Address - State:MA
Mailing Address - Zip Code:02468-2005
Mailing Address - Country:US
Mailing Address - Phone:617-971-3007
Mailing Address - Fax:
Practice Address - Street 1:158 UPLAND RD
Practice Address - Street 2:
Practice Address - City:WABAN
Practice Address - State:MA
Practice Address - Zip Code:02468-2005
Practice Address - Country:US
Practice Address - Phone:617-971-3007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1899481Medicaid
MA1899481Medicaid