# HYDE PARK BEHAVIORAL HEALTH

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

## Provider details

- **NPI number:** 1639765894
- **Authorized official:** CLARENCE T DENNIS PMHNP-BC (PSYCHIATRIC NURSE PRACTITIONER)
- **Authorized official phone:** (617) 413-6618

## Contact information

- **Practice address:** 1234 HYDE PARK AVE, BOSTON, MA 02136-2819
- **Practice address phone:** (617) 413-6618
- **Practice address fax:** (617) 333-8229
- **Mailing address:** 1234 HYDE PARK AVE, HYDE PARK, MA 02136-2819
- **Mailing address phone:** (617) 413-6618

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 12/11/2020
- **Last updated:** 11/09/2021