Organization
THE MCLEAN HOSPITAL CORPORATION
Active
Organization
THE MCLEAN HOSPITAL CORPORATION
Active
Other names
McLean Professional Practice Group
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH GOLD M.D. (CHIEF MEDICAL OFFICER)
(617) 855-2367
Entity
Organization
Contact information
Practice address
115 MILL ST, BELMONT, MA 02478-1041
(617) 855-2183
(617) 855-3745
Mailing address
P.O. BOX 5-0397, WOBURN, MA 01815-0397
(617) 855-2183
(617) 855-3745
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
364S00000X
Clinical Nurse Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1201174
—
MA
05
—
9778705
—
MA
01
—
M16400
BC/BS
MA
01
—
W10374
BC/BS
MA
Enumeration date
05/16/2006
Last updated
10/27/2010
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