Provider Demographics
NPI:1245291749
Name:HAKAMI, MALEKEH K (PHD)
Entity type:Individual
Prefix:
First Name:MALEKEH
Middle Name:K
Last Name:HAKAMI
Suffix:
Gender:F
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:PO BOX 81326
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY HILLS
Mailing Address - State:MA
Mailing Address - Zip Code:02481-0003
Mailing Address - Country:US
Mailing Address - Phone:617-390-1312
Mailing Address - Fax:617-390-1576
Practice Address - Street 1:77 POND AVE
Practice Address - Street 2:SUITE 101 THE BROOK HOUSE
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-7141
Practice Address - Country:US
Practice Address - Phone:617-390-1312
Practice Address - Fax:617-390-1576
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-01
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3964103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA406697OtherTUFTS
MAW03925OtherBLUE CROSS BLUE SHIELD
MA0501450Medicaid
MAW03925Medicare ID - Type Unspecified