Provider Demographics
NPI:1457827586
Name:DOWNES, PATRICK B (PSYD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:B
Last Name:DOWNES
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 MERRIMAC ST FL 2
Mailing Address - Street 2:MGH
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-4724
Mailing Address - Country:US
Mailing Address - Phone:617-724-5202
Mailing Address - Fax:
Practice Address - Street 1:101 MERRIMAC ST FL 2
Practice Address - Street 2:MGH
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-4724
Practice Address - Country:US
Practice Address - Phone:617-724-5202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-16
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA390200000X
MA11652103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program