Provider Demographics
NPI:1487708632
Name:PSYCHOLOGICAL CONSULTING, P.C.
Entity type:Organization
Organization Name:PSYCHOLOGICAL CONSULTING, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIE LISE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROYER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:781-224-2820
Mailing Address - Street 1:PO BOX 1860
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-5860
Mailing Address - Country:US
Mailing Address - Phone:781-224-2820
Mailing Address - Fax:781-224-0074
Practice Address - Street 1:8 CEDAR ST
Practice Address - Street 2:SUITE 58
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-7246
Practice Address - Country:US
Practice Address - Phone:781-224-2820
Practice Address - Fax:781-224-0074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4876103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA001859OtherHPHC-PACIFICARE
MA135081OtherVALUEOPTIONS
MA5098732OtherAETNA BEH. HEALTH
MA790711OtherTUFTS HEALTH PLAN MEDICARE PREFERRED
MAW05512OtherBC/BS OF MA FOR 'MARIE LISE ROYER'
MAW10505OtherEMPIRE BCBS, EIN#
MA102931OtherMBH-MAGELLAN
MA1899112Medicaid
MA790711OtherTUFTS-NAVIGATOR,MYNAME&SS
MA790711OtherTUFTS HEALTH PLANS
MAW10505OtherBC/BS OF MA FOR 'PSYCHOLOGICAL CONSULTING, P.C.'
MAW05512Medicare ID - Type UnspecifiedMARIE LISE ROYER, PH.D.
MA1899112Medicaid