Provider Demographics
NPI:1396116133
Name:SZAFRAN, PATRICK MICHAEL (PSYD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:MICHAEL
Last Name:SZAFRAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-4506
Mailing Address - Country:US
Mailing Address - Phone:847-868-0142
Mailing Address - Fax:
Practice Address - Street 1:9 NORTH ST UNIT 5
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-4183
Practice Address - Country:US
Practice Address - Phone:847-868-0142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-19
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11488103TC0700X
IL071009159103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical