Organization
CLINICAL ALLIANCES SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISSA DUTRA PH.D. (PRINCIPAL)
(617) 307-4470
Entity
Organization
Contact information
Practice address
10 CONCORD AVE, CAMBRIDGE, MA 02138-2322
(617) 230-3002
(617) 849-5863
Mailing address
10 CONCORD AVE, CAMBRIDGE, MA 02138-2322
(617) 307-4470
(617) 849-5863
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
9008
MA
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1912113564
NPI
MA
Enumeration date
09/04/2018
Last updated
09/04/2018
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