Provider Demographics
NPI:1649350240
Name:HORVITZ, JAMES (PHD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:HORVITZ
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 1:27 GLEN ST STE 13
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-2481
Mailing Address - Country:US
Mailing Address - Phone:781-344-0998
Mailing Address - Fax:
Practice Address - Street 1:27 GLEN ST STE 13
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-2481
Practice Address - Country:US
Practice Address - Phone:781-682-1060
Practice Address - Fax:781-682-1061
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1857103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW01972OtherBCBS PROVIDER NUMBER
MD0511595Medicaid
MA6101040OtherEVERCARE PROVIDER NUMBER
MD0511595Medicaid