Anita J Avakian
Individual provider Active NPI Clinical Psychologist · Bridgewater, MA
NPI 1356933014 · NPPES record last updated Feb 4, 2021
Key facts
- NPI
- 1356933014
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 10828 (MA)
- Practice address
- 1 Administration Rd # 2324
Bridgewater, MA 02324-3230 - Phone
- (508) 279-4500
- NPI assigned
- Feb 4, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10828 | MA | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 10828 | MA | Yes |
Addresses
Primary practice location
1 Administration Rd # 2324
Bridgewater, MA 02324-3230
Mailing address
74 Cannon Forge Dr # 2035
Foxborough, MA 02035-5217
Phone (317) 294-4245
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- Jilia August
- Daniel Avila
- Lisa M Azar
- Amanda E Backstrom
- Ana Barend
- Erin Jean Barry
All providers in Bridgewater, 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 Feb 4, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.