| Lifedimensions Neuropsychological Services, Inc | |
|
250 Pond St Lifedimensions Neuropsychological Services, Inc. Braintree MA 02184-5351 | |
| (781) 348-2258 | |
| (781) 348-2132 |
| Full Name | Lifedimensions Neuropsychological Services, Inc |
|---|---|
| Speciality | Psychologist |
| Location | 250 Pond St, Braintree, Massachusetts |
| Authorized Official Name and Position | Marie M Walbridge (CLERK, CO-OWNER) |
| Authorized Official Contact | 7813483900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifedimensions Neuropsychological Services, Inc 250 Pond St Lifedimensions Neuropsychological Services, Inc. Braintree MA 02184-5351 Ph: (781) 348-2258 | Lifedimensions Neuropsychological Services, Inc 250 Pond St Lifedimensions Neuropsychological Services, Inc. Braintree MA 02184-5351 Ph: (781) 348-2258 |
| NPI Number | 1932172632 |
|---|---|
| Provider Enumeration Date | 02/12/2006 |
| Last Update Date | 03/19/2011 |
| Medicare PECOS PAC ID | 4587654637 |
|---|---|
| Medicare Enrollment ID | O20040512001300 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932172632 | NPI | - | NPPES |
| 9721771 | Medicaid | MA | |
| W10469 | Other | MA | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 4712 (Massachusetts) | Secondary |
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Ashita Shyam Gurnani |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831703107 PECOS PAC ID: 5597185652 Enrollment ID: I20201012002372 |
| Provider Name | Nicole Coolbrith |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1568129542 PECOS PAC ID: 5193168052 Enrollment ID: I20240207002518 |
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