Provider Demographics
NPI:1386310670
Name:CAMBRIDGE CENTER FOR NEUROPSYCHOLOGY AND LEARNING
Entity type:Organization
Organization Name:CAMBRIDGE CENTER FOR NEUROPSYCHOLOGY AND LEARNING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:HYDE
Authorized Official - Last Name:O'BRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:617-354-5050
Mailing Address - Street 1:2464 MASSACHUSETTS AVE STE 230
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-1649
Mailing Address - Country:US
Mailing Address - Phone:617-354-5050
Mailing Address - Fax:617-945-5492
Practice Address - Street 1:2464 MASSACHUSETTS AVE STE 230
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02140-1649
Practice Address - Country:US
Practice Address - Phone:617-354-5050
Practice Address - Fax:617-945-5492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty