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BROOKSIDE COUNSELING ASSOCIATES LLC NPI 1417069410


NPI Information

NPI: 1417069410
Provider Name: BROOKSIDE COUNSELING ASSOCIATES LLC
Classification: Psychologist - 103TC0700X
Entity Type: Organization

Specialization: Clinical

Address:
62 DERBY ST
STE 13
HINGHAM, MA
ZIP 02043
Phone: (781) 749-4600
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BROOKSIDE COUNSELING ASSOCIATES LLC is a clinical psychologist in Hingham, MA. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. BROOKSIDE COUNSELING ASSOCIATES LLC NPI is 1417069410. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

62 DERBY ST
STE 13
HINGHAM, MA
ZIP 02043
Phone: (781) 749-4600
Fax: (781) 741-8341

The provider's authorized official is John David Eckelman .
The authorized official title is Managing Partner and has the following contact phone number (781) 749-4600.

The enumeration date for this NPI number is 8/31/2006 and was last updated on 8/22/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TC0700XPsychologistClinicalYes
21041C0700XSocial WorkerClinicalX

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11005990OTHERMASSACHUSETTSBEACON HEALTH STRATEGIES
2P10213OTHERMASSACHUSETTSBCBS FOR CLINICAL SOCIAL
3W10414OTHERMASSACHUSETTSBCBS FOR PSYCHOLOGISTS
4667145OTHERMASSACHUSETTSTUFTS HEALTH PLANS

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: 4/28/2024

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