Provider Demographics
NPI:1932204377
Name:DOOLIN, SETH ALEXANDRE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SETH
Middle Name:ALEXANDRE
Last Name:DOOLIN
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 CAMBRIDGE ST STE 300
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-3768
Mailing Address - Country:US
Mailing Address - Phone:857-205-3156
Mailing Address - Fax:
Practice Address - Street 1:101 CAMBRIDGE ST STE 300
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-3768
Practice Address - Country:US
Practice Address - Phone:857-205-3156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103G00000X
MA8580103TC0700X, 103TM1800X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1089420OtherBEACON HEALTH/FALLON
MAW06582OtherBLUE CROSS BLUE SHIELD
MA0584851Medicaid
MA11717963OtherCAQH
MA11717963OtherCAQH