Heidi Lack, PHD, Atr-BC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

7518 Issued in MA

Legal business name

HEIDI LACK, PHD, ATR-BC

Practice address

16 Clarke St Ste 23
Lexington, MA 02421-4938

Phone

(781) 863-8696

NPI assigned

Jul 14, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Heidi Lack, PHD, ATR-BC

Title

Director, Psychologistart Therapist

Phone

(781) 863-8696

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405296000000",
    "number": "1740697523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 CLARKE ST STE 23",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024214938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 CLARKE ST STE 23",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024214938",
            "telephone_number": "781-863-8696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEIDI LACK, PHD, ATR-BC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-14",
        "last_updated": "2014-07-14",
        "status": "A",
        "authorized_official_last_name": "LACK",
        "authorized_official_first_name": "HEIDI",
        "authorized_official_title_or_position": "DIRECTOR, PSYCHOLOGISTART THERAPIST",
        "authorized_official_telephone_number": "781-863-8696",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, ATR-BC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MA",
            "license": "7518",
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "MA",
            "license": "7518",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "MA",
            "license": "7518",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Liam Henson
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• Mental Health Clinic/Center (Including Community Mental Health Center) in Lexington, MA
• Providers in Lexington, MA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2014; 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.