Provider Demographics
NPI:1013901651
Name:GRUBMAN, JAMES A (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:GRUBMAN
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 1:356 MONTAGUE CITY RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TURNERS FALLS
Mailing Address - State:MA
Mailing Address - Zip Code:01376-1830
Mailing Address - Country:US
Mailing Address - Phone:413-775-0557
Mailing Address - Fax:
Practice Address - Street 1:356 MONTAGUE CITY RD
Practice Address - Street 2:SUITE 100
Practice Address - City:TURNERS FALLS
Practice Address - State:MA
Practice Address - Zip Code:01376-1830
Practice Address - Country:US
Practice Address - Phone:413-775-0557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-09
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7419103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW05794OtherBCBSMA
MAW05794OtherBCBSMA