Provider Demographics
NPI:1922770031
Name:KURAHARA, LINDSAY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:
Last Name:KURAHARA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 EASTBROOK RD STE 101
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-2083
Mailing Address - Country:US
Mailing Address - Phone:857-293-5020
Mailing Address - Fax:857-226-8772
Practice Address - Street 1:30 EASTBROOK RD STE 101
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-2083
Practice Address - Country:US
Practice Address - Phone:857-293-5020
Practice Address - Fax:857-226-8772
Is Sole Proprietor?:No
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11555103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000OtherN/A