| Highland Psychological Associates, Llc | |
|
875 Massachusetts Ave Suite 71 Cambridge MA 02139-3067 | |
| (857) 600-0875 | |
| Not Available |
| Full Name | Highland Psychological Associates, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 875 Massachusetts Ave, Cambridge, Massachusetts |
| Authorized Official Name and Position | Kelly R Wilson (OWNER) |
| Authorized Official Contact | 8576000875 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Highland Psychological Associates, Llc 875 Massachusetts Ave Suite 71 Cambridge MA 02139-3067 Ph: (857) 600-0875 | Highland Psychological Associates, Llc 875 Massachusetts Ave Suite 71 Cambridge MA 02139-3067 Ph: (857) 600-0875 |
| NPI Number | 1033453584 |
|---|---|
| Provider Enumeration Date | 11/23/2012 |
| Last Update Date | 08/14/2015 |
| Medicare PECOS PAC ID | 0840501326 |
|---|---|
| Medicare Enrollment ID | O20150624003002 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033453584 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 9580 (Massachusetts) | Primary |
| Provider Name | Kelly R Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740596279 PECOS PAC ID: 9537474341 Enrollment ID: I20150821013797 |
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