Organization
INNOPSYCH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARMAIN JACKMAN PHD (PRESIDENT)
(617) 803-2417
Entity
Organization
Contact information
Practice address
40 SPRING ST STE 3, WATERTOWN, MA 02472-3476
(617) 803-2417
Mailing address
PO BOX 894, WATERTOWN, MA 02471-0894
(617) 803-2417
(617) 500-9710
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
70010000W06742
BCBS
MA
Enumeration date
03/01/2019
Last updated
03/01/2019
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