Provider Demographics
NPI: | 1205926946 |
---|---|
Name: | NEUROBEHAVIORAL ASSOCIATES III, INC |
Entity type: | Organization |
Organization Name: | NEUROBEHAVIORAL ASSOCIATES III, INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | RACHAEL |
Authorized Official - Middle Name: | A |
Authorized Official - Last Name: | DARIAN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | APRN |
Authorized Official - Phone: | 781-682-1060 |
Mailing Address - Street 1: | 169 LIBBEY INDUSTRIAL PKWY |
Mailing Address - Street 2: | 2ND FLOOR |
Mailing Address - City: | WEYMOUTH |
Mailing Address - State: | MA |
Mailing Address - Zip Code: | 02189-3101 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 781-682-1060 |
Mailing Address - Fax: | 781-682-1061 |
Practice Address - Street 1: | 169 LIBBEY INDUSTRIAL PKWY |
Practice Address - Street 2: | 2ND FLOOR |
Practice Address - City: | WEYMOUTH |
Practice Address - State: | MA |
Practice Address - Zip Code: | 02189-3101 |
Practice Address - Country: | US |
Practice Address - Phone: | 781-682-1060 |
Practice Address - Fax: | 781-682-1061 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-10-13 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Not Answered | 103G00000X | Behavioral Health & Social Service Providers | Clinical Neuropsychologist | Group - Multi-Specialty | |
Not Answered | 103TC0700X | Behavioral Health & Social Service Providers | Psychologist | Clinical | Group - Multi-Specialty |
Not Answered | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
Not Answered | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | Group - Multi-Specialty |
Not Answered | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Multi-Specialty |
Not Answered | 2084P0805X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Geriatric Psychiatry | Group - Multi-Specialty |
Not Answered | 364SP0807X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Psychiatric/Mental Health, Child & Adolescent | Group - Multi-Specialty |
Not Answered | 364SP0809X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Psychiatric/Mental Health, Adult | Group - Multi-Specialty |
Not Answered | 364SP0813X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Psychiatric/Mental Health, Geropsychiatric | Group - Multi-Specialty |