| Commonwealth Family Psychological Associates, P.c. | |
|
204 Lafayette St Salem MA 01970-4721 | |
| (978) 744-5006 | |
| (978) 744-9799 |
| Full Name | Commonwealth Family Psychological Associates, P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 204 Lafayette St, Salem, Massachusetts |
| Authorized Official Name and Position | Evan Mark Longin (PRESIDENT) |
| Authorized Official Contact | 9787445006 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Commonwealth Family Psychological Associates, P.c. 204 Lafayette St Salem MA 01970-4721 Ph: (978) 744-5006 | Commonwealth Family Psychological Associates, P.c. 204 Lafayette St Salem MA 01970-4721 Ph: (978) 744-5006 |
| NPI Number | 1841375995 |
|---|---|
| Provider Enumeration Date | 10/26/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 4082780176 |
|---|---|
| Medicare Enrollment ID | O20080915000452 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841375995 | NPI | - | NPPES |
| 702714 | Other | MA | TUFTS HEALTH PLAN |
| W10108 | Other | MA | BCBS OF MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Evan M Longin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902981079 PECOS PAC ID: 8325115413 Enrollment ID: I20080915000496 |
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