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Contact Information

ADVANCED NEUROTHERAPY, PC
140 BRISTOL RD
WELLESLEY, MA02481-2730
 Phone: 781-444-9115
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Cognitive & Behavioral

103TB0200X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for ADVANCED NEUROTHERAPY, PC

NPI Number 1104846476
LBN Legal business name ADVANCED NEUROTHERAPY, PC
Authorized official JOLENE ROSS - (LICENSED PSYCHOLOGIST/DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 07/20/2006
Last updated 06/15/2023 - About 3 years ago
Identifiers
MA License # 3976
MA Other W03950 BCBS PROVIDER #
MA Other W03950 NATIONAL HERITAGE
MA Other 722869 TUFTS COMMERCIAL
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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