Provider Demographics
NPI:1154942613
Name:DORAN, LUCINDA IRVINE (PHD)
Entity type:Individual
Prefix:DR
First Name:LUCINDA
Middle Name:IRVINE
Last Name:DORAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 KILSYTH RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-2001
Mailing Address - Country:US
Mailing Address - Phone:617-901-6083
Mailing Address - Fax:
Practice Address - Street 1:21 KILSYTH RD
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-2001
Practice Address - Country:US
Practice Address - Phone:617-901-6083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-06
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6851-PY-PY103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist