NPIMap

Organization Active NPI

Hallowell Center

  • Psychologist
  • Needham, MA
National Provider Identifier
1073843249
Registry record updated Jan 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
7963 Issued in MA
Legal business name
HALLOWELL CENTER
Practice address
75 2ND Ave
Suite 310
Needham, MA 02494-2820
Phone
(781) 726-6698
Fax
(781) 726-6725
NPI assigned
Jan 11, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Thor Bergersen, M.D.NPI 1013112796
Title
C.E.O
Phone
(781) 726-6698

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 7963 MA Primary

Addresses

Primary practice location

75 2ND Ave
Suite 310
Needham, MA 02494-2820

Mailing address

75 2ND Ave
Suite 310
Needham, MA 02494-2820
Phone (781) 726-6698

National Provider Directory

National Provider Directory
Tax ID family
ADHD Boston2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1263168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263168000000",
    "number": "1073843249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 2ND AVE",
            "address_2": "SUITE 310",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024942820",
            "telephone_number": "781-726-6698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 2ND AVE",
            "address_2": "SUITE 310",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024942820",
            "telephone_number": "781-726-6698",
            "fax_number": "781-726-6725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HALLOWELL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-11",
        "last_updated": "2010-01-11",
        "status": "A",
        "authorized_official_last_name": "BERGERSEN",
        "authorized_official_first_name": "THOR",
        "authorized_official_title_or_position": "C.E.O",
        "authorized_official_telephone_number": "781-726-6698",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "MA",
            "license": "7963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Needham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.