Organization
LEADERSHIP PSYCHOLOGY SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL CASSELLA PH.D. (PRESIDENT)
(978) 393-1925
Entity
Organization
Contact information
Practice address
747 MAIN ST, SUITE #319, CONCORD, MA 01742-3302
(978) 393-1925
Mailing address
102 SOUTH RD, PEPPERELL, MA 01463-1257
Taxonomy
Speciality
Code
Description
License number
State
103TA0700X
Adult Development & Aging Psychologist
9751
MA
103TB0200X
Cognitive & Behavioral Psychologist
9751
MA
103TC0700X
Clinical Psychologist
Primary
9751
MA
103TP2701X
Group Psychotherapy Psychologist
9751
MA
Other
Enumeration date
02/01/2016
Last updated
05/31/2016
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