ALICE DIANE DOMAR PH.D. NPI 1417902099

NPI Information

NPI: 1417902099
Provider Name: ALICE DIANE DOMAR, PH.D.
Classification: Psychologist - 103TB0200X
Entity Type: Individual

Specialization: Cognitive & Behavioral

Address:
130 2ND AVE
BOSTON IVF - DOMAR CENTER
WALTHAM, MA
ZIP 02451
Phone: (781) 434-6578
Get Directions

Alice Diane Domar, PH.D. is a cognitive and behavioral psychologist in Waltham, MA. The provider is a psychologist who reflects an experimental-clinical approach distinguished by use of principles of human learning and development and theories of cognitive processing to promote meaningful change in maladaptive human behavior and thinking. Alice Diane Domar, PH.D. NPI is 1417902099. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

130 2ND AVE
BOSTON IVF - DOMAR CENTER
WALTHAM, MA
ZIP 02451-100
Phone: (781) 434-6578
Fax: (781) 370-2330

The enumeration date for this NPI number is 5/23/2006 and was last updated on 9/1/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	103TC0700X	Psychologist	Clinical	4308	MASSACHUSETTS	No
2	103TC1900X	Psychologist	Counseling	4308	MASSACHUSETTS	No
3	103TF0000X	Psychologist	Family	4308	MASSACHUSETTS	No
4	103TH0100X	Psychologist	Health Service	4308	MASSACHUSETTS	No
5	103T00000X	Psychologist		4308	MASSACHUSETTS	No
6	103TP2701X	Psychologist	Group Psychotherapy	4308	MASSACHUSETTS	No
7	103TB0200X	Psychologist	Cognitive & Behavioral	4308	MASSACHUSETTS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	W04271	MEDICARE ID-TYPE UNSPECIFIED	MASSACHUSETTS
2	E23404	MEDICARE UPIN	MASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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