DIANA HEARST IKEDA, PhD, Cognitive & Behavioral DUXBURY, MA

Contact Information

DIANA HEARST IKEDA, PhD

20 TREMONT ST
SUITE 12 A
DUXBURY, MA 02332-5310

Phone: 781-934-6390
Fax: 781-934-9991
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Cognitive & Behavioral	103TB0200X	62	Psychologist, Clinical
Addiction (Substance Use Disorder)	101YA0400X
Addiction (Substance Use Disorder)	103TA0400X	62	Psychologist, Clinical
Adult Development & Aging	103TA0700X	62	Psychologist, Clinical
Clinical	103TC0700X	62	Psychologist, Clinical
Clinical Child & Adolescent	103TC2200X	62	Psychologist, Clinical
Counseling	103TC1900X	62	Psychologist, Clinical
Family	103TF0000X	62	Psychologist, Clinical
Mental Health	101YM0800X
Psychologist	103T00000X	62	Psychologist, Clinical

Indicates primary specialty

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NPI Profile & details for DIANA HEARST IKEDA · (Female)

NPI Number	`1124146717`
Status	Active
Credentials	PhD
Entity	Individual
Enumeration date	03/26/2007
Last updated	12/13/2013 - About 12 years ago
Sole proprietor ¹	Yes
Identifiers	MA License # 6917 MA Medicaid W05211 MA Other W05611 BLUE CROSS BLUE SHIELD MA Other 407109 TUFTS BEHAVIORAL HEALTH
Hospital affiliation(s)	Not Available

¹ A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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DIANA HEARST IKEDA, PhD – NPI #1124146717Cognitive & Behavioral

Contact Information

Specialty

NPI Profile & details for DIANA HEARST IKEDA · (Female)

Reviews for DIANA HEARST IKEDA

DIANA HEARST IKEDA, PhD – NPI #1124146717
Cognitive & Behavioral