Provider Demographics
NPI:1982195632
Name:WINSMANN, FREDERICK (PHD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:
Last Name:WINSMANN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:262 BEACON ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-1200
Mailing Address - Country:US
Mailing Address - Phone:857-231-2692
Mailing Address - Fax:857-239-9311
Practice Address - Street 1:262 BEACON ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-1200
Practice Address - Country:US
Practice Address - Phone:857-231-2692
Practice Address - Fax:857-239-9311
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8833103TC0700X, 103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical