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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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