Organization
RICHMOND PSYCHIATRY GROUP PRACTICE
Active
Parent organization
CHILDREN'S HOSPITAL CORPORATION
Other names
Richmond Psychiatry Group Practice
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHILDREN'S HOSPITAL CORPORATION
Authorized official
MR. STEVEN D NICOLL (DIRECTOR PATIENT FINANCIAL SERVICE)
(857) 218-3391
Entity
Organization
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-4831
(617) 730-0080
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-4831
(617) 730-0080
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
MA
103TC0700X
Clinical Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
1041C0700X
Clinical Social Worker
—
MA
2084P0800X
Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103TP2701X
PSYCHIATRY
MA
Enumeration date
11/09/2006
Last updated
03/13/2023
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