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Organization

TRIAD ADOLESCENT SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GILLIAN CAROL GALEN PSYD (CLINICAL DIRECTOR)
(617) 290-9432
Entity
Organization

Contact information

Practice address
363 MASS AVE, SUITE 204, LEXINGTON, MA 02420
(781) 864-4814
Mailing address
363 MASS AVE, SUITE 204, LEXINGTON, MA 02420
(781) 864-4814

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
2353
MA
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
9159
MA

Other

Enumeration date
01/03/2014
Last updated
01/03/2014
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