Therapeutic Psychiatric Service

Primary specialty

Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X

License

RN217927 Issued in MA

Legal business name

THERAPEUTIC PSYCHIATRIC SERVICE

Practice address

131 Harvard St
Brookline, MA 02446-6429

Phone

(617) 232-4570

NPI assigned

Oct 18, 2011

Organization subpart

No

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

Authorized official

Name

Donna Lyder, PMH, CNS, BC

Title

Clinician/Owner

Phone

(617) 232-4570

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1318896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318896000000",
    "number": "1497030795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 HARVARD STREET",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "02446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 HARVARD ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024466429",
            "telephone_number": "617-232-4570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPEUTIC PSYCHIATRIC SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-18",
        "last_updated": "2011-10-18",
        "status": "A",
        "authorized_official_last_name": "LYDER",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "CLINICIAN/OWNER",
        "authorized_official_telephone_number": "617-232-4570",
        "authorized_official_credential": "PMH, CNS, BC"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN217927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110073091A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Clinical Nurse Specialist in Brookline, MA
• Providers in Brookline, MA by specialty
• Psychiatric/Mental Health Clinical Nurse Specialist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2011; 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.