Organization
CAMBRIDGE EATING DISORDER CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SEDA EBRAHIMI-KESHISHIAN PH.D. (PRESIDENT)
(617) 547-2255
Entity
Organization
Contact information
Practice address
3 BOW ST, CAMBRIDGE, MA 02138-5103
(617) 547-2255
(617) 547-0003
Mailing address
3 BOW ST, CAMBRIDGE, MA 02138-5103
(617) 547-2255
(617) 547-0003
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
6214
MA
103TC2200X
Clinical Child & Adolescent Psychologist
6214
MA
103TF0000X
Family Psychologist
6214
MA
103TP2701X
Group Psychotherapy Psychologist
6214
MA
1041C0700X
Clinical Social Worker
6214
MA
323P00000X
Psychiatric Residential Treatment Facility
Primary
MB-PRF-914
MA
Other
Enumeration date
03/19/2007
Last updated
11/14/2014
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