Organization
COMMONWEALTH COUNSELING ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN MYRNA WEISS (PSYCHOLOGIST)
(617) 361-4548
Entity
Organization
Contact information
Practice address
695 TRUMAN HWY STE 203, HYDE PARK, MA 02136-3552
(617) 361-4548
Mailing address
695 TRUMAN HWY STE 203, HYDE PARK, MA 02136-3552
(617) 361-4548
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
705447
TUFTS
MA
01
—
W10270
BLUE CROSS BLUE SHIELD
MA
Enumeration date
05/04/2007
Last updated
08/22/2020
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