Provider Demographics
NPI:1841563558
Name:COMPREHENSIVE PSYCHIATRIC RESOURCES, INC
Entity Type:Organization
Organization Name:COMPREHENSIVE PSYCHIATRIC RESOURCES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:R
Authorized Official - Last Name:BERKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-647-0066
Mailing Address - Street 1:203 CRESCENT ST.
Mailing Address - Street 2:SUITE 110
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453
Mailing Address - Country:US
Mailing Address - Phone:781-647-0066
Mailing Address - Fax:781-899-4905
Practice Address - Street 1:203 CRESCENT ST.
Practice Address - Street 2:SUITE 110
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453
Practice Address - Country:US
Practice Address - Phone:781-647-0066
Practice Address - Fax:781-899-4905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-13
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6577101YM0800X
MA114896 (LICSW)104100000X
MA116604 (LICSW)104100000X
MA217495 (LCSW)104100000X
MA2793 (RD)133V00000X
MA703332084P0800X
MARN238050363LP0808X
MARN258504363LP0808X
MARN163877363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty