NPIMap

Organization Active NPI

Supportive Behavioral Care of Ma LLC

  • Clinical Psychologist
  • Needham, MA
National Provider Identifier
1780115519
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
SUPPORTIVE BEHAVIORAL CARE OF MA LLC
Practice address
150 Lincoln St
Needham, MA 02492-2914
Phone
(718) 298-4375
NPI assigned
Mar 23, 2017
Last updated
Sep 3, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Authorized official

Name
Raphael Lichtschein
Title
President
Phone
(718) 298-4375

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X Primary

Addresses

Primary practice location

150 Lincoln St
Needham, MA 02492-2914

Mailing address

14 Shemen St
Lakewood, NJ 08701-3662

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170614000877 MA Part B Supplier - Clinic/Group Practice 8628346731 Receives reassigned benefits from 227 practitioners
Practice locations: Boston, MA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 230

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.

View all 230

NPI Registry JSON

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788393600000",
    "number": "1780115519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 SHEMEN ST",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087013662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 LINCOLN ST",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024922914",
            "telephone_number": "718-298-4375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPORTIVE BEHAVIORAL CARE OF MA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-23",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A",
        "authorized_official_last_name": "LICHTSCHEIN",
        "authorized_official_first_name": "RAPHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-298-4375"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Needham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.