# CAMBRIDGE EATING DISORDER CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518081108
- **Authorized official:** DR. SEDA EBRAHIMI-KESHISHIAN PH.D. (PRESIDENT)
- **Authorized official phone:** (617) 547-2255

## Contact information

- **Practice address:** 3 BOW ST, CAMBRIDGE, MA 02138-5103
- **Practice address phone:** (617) 547-2255
- **Practice address fax:** (617) 547-0003
- **Mailing address:** 3 BOW ST, CAMBRIDGE, MA 02138-5103
- **Mailing address phone:** (617) 547-2255
- **Mailing address fax:** (617) 547-0003

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC0700X | Clinical Psychologist | 6214 | MA | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | 6214 | MA | — |
| 103TF0000X | Family Psychologist | 6214 | MA | — |
| 103TP2701X | Group Psychotherapy Psychologist | 6214 | MA | — |
| 1041C0700X | Clinical Social Worker | 6214 | MA | — |
| 323P00000X | Psychiatric Residential Treatment Facility | MB-PRF-914 | MA | Yes |

## Other

- **Enumeration date:** 03/19/2007
- **Last updated:** 11/14/2014