Provider Demographics
NPI:1194934026
Name:CENTRAL SQUARE THERAPY ASSOCIATES L.L.P.
Entity type:Organization
Organization Name:CENTRAL SQUARE THERAPY ASSOCIATES L.L.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGEING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:781-592-6100
Mailing Address - Street 1:150 MARKET ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01901-1529
Mailing Address - Country:US
Mailing Address - Phone:781-592-6100
Mailing Address - Fax:781-592-1093
Practice Address - Street 1:150 MARKET ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901-1529
Practice Address - Country:US
Practice Address - Phone:781-592-6100
Practice Address - Fax:781-592-1093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA103TC0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA395667OtherMAGELLAN BEHAVIORAL HEALT
MA1028620OtherBEACON HEALTH STRATEGIES