HYDE PARK BEHAVIORAL HEALTH NPI 1568127157

NPI Information

HYDE PARK BEHAVIORAL HEALTH is a psychiatric/mental health nurse practitioner in Boston, MA. HYDE PARK BEHAVIORAL HEALTH NPI is 1568127157. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1234 HYDE PARK AVE STE 205
BOSTON, MA
ZIP 02136-819
Phone: (617) 413-6618
Fax: (617) 333-8229

The provider's authorized official is Clarence Theodore Dennis .
The authorized official title is Psychiatric Nurse Practitioner and has the following contact phone number (617) 413-6618.

The CLIA number assigned to this NPI record is 22D0075458 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 11/8/2021 and was last updated on 11/8/2021.

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:

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