NPIMap

Organization Active NPI

Bostonneurobehavioralassociates

  • Legal Medicine
  • Dedham, MA
National Provider Identifier
1518043587
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
Legal business name
BOSTONNEUROBEHAVIORALASSOCIATES
Practice address
80 Bridge St
Dedham, MA 02026-1765
Phone
(781) 492-1689
NPI assigned
Oct 31, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Laurie Pitchford, LSW
Title
Directorofoutpatientservices
Phone
(781) 492-1689

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal Medicine 173000000X MA Primary

Addresses

Primary practice location

80 Bridge St
Dedham, MA 02026-1765

Mailing address

80 Bridge St
Dedham, MA 02026-1765
Phone (781) 492-1689

Other identifiers 1

IdentifierTypeStateIssuer
974608MedicaidMA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1518043587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 BRIDGE ST",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020261765",
            "telephone_number": "781-492-1689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 BRIDGE ST",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020261765",
            "telephone_number": "781-492-1689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTONNEUROBEHAVIORALASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PITCHFORD",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "DIRECTOROFOUTPATIENTSERVICES",
        "authorized_official_telephone_number": "17814921689",
        "authorized_official_credential": "LSW"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "974608",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dedham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.