Provider Demographics
NPI:1811060056
Name:NEEDHAM PSYCHOTHERAPY ASSOCIATES LLC
Entity type:Organization
Organization Name:NEEDHAM PSYCHOTHERAPY ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:GIFFORD BARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:617-901-1298
Mailing Address - Street 1:1040 GREAT PLAIN AVENUE
Mailing Address - Street 2:THIRD FLOOR, SUITE A
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492
Mailing Address - Country:US
Mailing Address - Phone:781-449-3122
Mailing Address - Fax:781-449-3134
Practice Address - Street 1:1040 GREAT PLAIN AVENUE
Practice Address - Street 2:THIRD FLOOR, SUITE A
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492
Practice Address - Country:US
Practice Address - Phone:781-449-3122
Practice Address - Fax:781-449-3134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA668312OtherTUFTS