Acton Psychological Associates LLC
Organization Active NPI Clinical Psychologist · Acton, MA
NPI 1013419381 · NPPES record last updated Mar 2, 2018
Key facts
- NPI
- 1013419381
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 7814 (MA)
- Legal business name
- ACTON PSYCHOLOGICAL ASSOCIATES LLC
- Practice address
- 532 Great Rd
Acton, MA 01720-3415 - Phone
- (508) 785-5518
- NPI assigned
- Mar 2, 2018
- Organization subpart
- No
Authorized official
- Name
- Dr. Eleanor Kent Fulton, PSY.D.
- Title
- Director/Owner
- Phone
- (508) 785-5518
Practitioners 1
-
Eleanor Kent Fulton, PSY.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180417000136 | MA | Part B Supplier - Clinic/Group Practice | 7214290741 |
Receives reassigned benefits from 1 practitioner Practice locations: Acton, MA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist |
103TC0700X | 7814 | MA | Yes |
Addresses
Primary practice location
532 Great Rd
Acton, MA 01720-3415
Mailing address
74 Meadowview Rd
Groton, MA 01450-1051
Phone (508) 785-5518
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All providers in Acton, MA · Clinical Psychologist in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 2, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.