Provider Demographics
NPI:1992025506
Name:ASCENDANT PSYCHIATRIC & CONSULTING CENTRE
Entity Type:Organization
Organization Name:ASCENDANT PSYCHIATRIC & CONSULTING CENTRE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CARMODY-KACZOR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:781-556-5662
Mailing Address - Street 1:175 DERBY ST
Mailing Address - Street 2:STE 21-22
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-4007
Mailing Address - Country:US
Mailing Address - Phone:781-556-5662
Mailing Address - Fax:781-836-0676
Practice Address - Street 1:175 DERBY ST
Practice Address - Street 2:STE 21-22
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-4007
Practice Address - Country:US
Practice Address - Phone:781-556-5662
Practice Address - Fax:781-836-0676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-04
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6175103TB0200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty