Organization Active NPI

Third Wave Therapy & Training PLLC

  • Clinical Psychologist
  • Concord, MA
National Provider Identifier
1386594125
Registry record updated Feb 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
THIRD WAVE THERAPY & TRAINING PLLC
Practice address
86 Baker Avenue Ext Ste 307
Concord, MA 01742-2132
Phone
(508) 366-7707
Fax
(978) 233-4696
NPI assigned
Jan 31, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2026

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

Authorized official

Name
Dr. Christy Clark, PHDNPI 1760411102
Title
Manager
Phone
(774) 261-0979

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
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

86 Baker Avenue Ext Ste 307
Concord, MA 01742-2132

Mailing address

86 Baker Avenue Ext Ste 307
Concord, MA 01742-2132
Phone (508) 366-7707

National Provider Directory

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1769817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769990400000",
    "number": "1386594125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 BAKER AVENUE EXT STE 307",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017422132",
            "telephone_number": "508-366-7707",
            "fax_number": "978-233-4696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 BAKER AVENUE EXT STE 307",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017422132",
            "telephone_number": "508-366-7707",
            "fax_number": "978-233-4696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THIRD WAVE THERAPY & TRAINING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-31",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "774-261-0979",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2026; 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.