NPIMap

Organization Active NPI

Psychological Care Associates, P.C.

  • Clinical Psychologist
  • Woburn, MA
National Provider Identifier
1194770479
Registry record updated Jul 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
PSYCHOLOGICAL CARE ASSOCIATES, P.C.
Practice address
12 Alfred St
Suite 200
Woburn, MA 01801-1972
Phone
(781) 646-0500
Fax
(781) 646-7130
NPI assigned
May 24, 2006
Last updated
Jul 6, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2009

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

Authorized official

Name
Michael F Jacques, PH.D.NPI 1144289240
Title
Director/Owner
Phone
(781) 646-0500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X NU Primary

Addresses

Primary practice location

12 Alfred St
Suite 200
Woburn, MA 01801-1972

Mailing address

12 Alfred Street
Suite 200
Woburn, MA 01801-1915
Phone (781) 646-0500

National Provider Directory

National Provider Directory

Locations

321 Billerica Rd
#104
Chelmsford, MA 01824

170 Main St
Unit G02
Tewksbury, MA 01876
Phone (617) 969-7600

Practitioners & affiliated clinicians

Practitioners 50

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 50

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246838400000",
    "number": "1194770479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 ALFRED STREET",
            "address_2": "SUITE 200",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018011915",
            "telephone_number": "781-646-0500",
            "fax_number": "781-646-7130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 ALFRED ST",
            "address_2": "SUITE 200",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018011972",
            "telephone_number": "781-646-0500",
            "fax_number": "781-646-7130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL CARE ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2009-07-06",
        "status": "A",
        "authorized_official_last_name": "JACQUES",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "781-646-0500",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2009; 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.