Provider Demographics
NPI:1932824430
Name:GREATER BOSTON ASSESSMENT & TREATMENT, LLC
Entity type:Organization
Organization Name:GREATER BOSTON ASSESSMENT & TREATMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER / CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BIRTWELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:617-651-2207
Mailing Address - Street 1:PO BOX 300730
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-0007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:747 MAIN ST STE 228
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-3302
Practice Address - Country:US
Practice Address - Phone:617-651-2207
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty