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Individual

DR. JOHN MINER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSY.D.

Contact information

Practice address
100 ELIOT ST, CHESTNUT HILL, MA 02467-1435
(617) 782-0303
Mailing address
10 PORTSMOUTH ST, BOSTON, MA 02135-1411
(617) 782-0303

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
4462
MA
103TA0700X
Adult Development & Aging Psychologist
4462
MA
103TC0700X
Clinical Psychologist
4462
MA
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
4462
MA
103TS0200X
School Psychologist
166523
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0495668
UNITED BEHAVIORAL HEALTH
MA
05
0518255
MA
01
13632
HANCOCK
MA
01
732087
TUFTS HEALTH CARE
MA
01
7764376
AETNA
MA
Enumeration date
07/19/2006
Last updated
09/11/2025
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