Provider Demographics
NPI:1588721294
Name:VORPAHL PSYCHOLGY ASSOCIATES, LLC
Entity type:Organization
Organization Name:VORPAHL PSYCHOLGY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:MELISSA
Authorized Official - Last Name:VORPAHL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:508-242-9666
Mailing Address - Street 1:258 MAIN ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:MEDFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02052-2041
Mailing Address - Country:US
Mailing Address - Phone:508-242-9666
Mailing Address - Fax:815-572-8941
Practice Address - Street 1:258 MAIN ST
Practice Address - Street 2:SUITE 3
Practice Address - City:MEDFIELD
Practice Address - State:MA
Practice Address - Zip Code:02052-2041
Practice Address - Country:US
Practice Address - Phone:508-242-9666
Practice Address - Fax:815-572-8941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7426103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW51242Medicare UPIN