Provider Demographics
NPI:1720464753
Name:MD PSYCHOLOGY LLC
Entity Type:Organization
Organization Name:MD PSYCHOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MAGGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NAUGHTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-297-0863
Mailing Address - Street 1:115 MAIN ST
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:NORTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02356-1409
Mailing Address - Country:US
Mailing Address - Phone:508-456-6287
Mailing Address - Fax:844-766-2013
Practice Address - Street 1:115 MAIN ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:NORTH EASTON
Practice Address - State:MA
Practice Address - Zip Code:02356-1409
Practice Address - Country:US
Practice Address - Phone:508-456-6287
Practice Address - Fax:844-766-2013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-31
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA278285103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty