Carol Becker, PHD

Individual provider Active NPI Clinical Psychologist · Watertown, MA

NPI 1508902115 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1508902115
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
3795 (MA)
Practice address
51 Kondazian St
Watertown, MA 02472-2830
Phone
(617) 924-2606
Fax
(617) 924-5111
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3795MAMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3795 MA Yes

Addresses

Primary practice location

51 Kondazian St
Watertown, MA 02472-2830

Mailing address

58 Todd Pond Rd
Lincoln, MA 01773-3808
Phone (781) 259-0921

Other providers in Watertown, MA

All providers in Watertown, MA · Clinical Psychologist in Massachusetts

Sources for this page

Verify at the official NPI Registry.