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BOURNEWOOD CLINICAL ASSOCIATES NPI 1891780144


NPI Information

NPI: 1891780144
Provider Name: BOURNEWOOD CLINICAL ASSOCIATES
Classification: Psychiatry & Neurology - 2084P0800X
Entity Type: Organization

Specialization: Psychiatry

CLIA Number: 22D0958264

Address:
300 SOUTH ST
BROOKLINE, MA
ZIP 02467
Phone: (617) 469-0300
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BOURNEWOOD CLINICAL ASSOCIATES is a psychiatry psychiatry neurology in Brookline, MA. The provider is a Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. BOURNEWOOD CLINICAL ASSOCIATES NPI is 1891780144. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

300 SOUTH ST
BROOKLINE, MA
ZIP 02467-658
Phone: (617) 469-0300
Fax: (617) 469-5013

The provider's authorized official is Michael C Gale .
The authorized official title is Cfo and has the following contact phone number (617) 469-0300.

The CLIA number assigned to this NPI record is 22D0958264 - hospital with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/13/2005 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
12084P0800XPsychiatry & NeurologyPsychiatryYes
21041C0700XSocial WorkerClinicalX
3103TC0700XPsychologistClinicalX
4363L00000XNurse PractitionerX

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
1M15391OTHERMASSACHUSETTSBLUE SHIELD PROVIDER NUMB
29773908MEDICAIDMASSACHUSETTS

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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