Professional Psychiatric Associates & Consultants PC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

34367 Issued in MA

Legal business name

PROFESSIONAL PSYCHIATRIC ASSOCIATES & CONSULTANTS PC

Practice address

16 Mica LN Ste 101
Wellesley Hills, MA 02481-1721

Phone

(781) 591-5221

Fax

(781) 235-6390

NPI assigned

Feb 7, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Douglas G Jacobs, M.D.

Title

President

Phone

(781) 591-5221

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700092800000",
    "number": "1295913747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 LILLIAN WAY",
            "city": "WAYLAND",
            "state": "MA",
            "postal_code": "017783030",
            "telephone_number": "781-591-5221",
            "fax_number": "781-235-6390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 MICA LN STE 101",
            "city": "WELLESLEY HILLS",
            "state": "MA",
            "postal_code": "024811721",
            "telephone_number": "781-591-5221",
            "fax_number": "781-235-6390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PSYCHIATRIC ASSOCIATES & CONSULTANTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-07",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-591-5221",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "34367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "M1439301",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Ploeger, BCBA, LABA
• Stanislava Portnoy, M.D.
• Mona Patel Potter, MD
• Daniela Poulat
• Presentation, LLC
• Psychotherapy & Wellness Center, LLC
• Brianna Quinn
• Colleen Quinn, OTR/L
• Talya Rabina, PSY.D.
• Raquel K. Perlis Physical Therapy, Inc.

• Psychiatry Physician in Wellesley Hills, MA
• Providers in Wellesley Hills, MA by specialty
• Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; 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.