Organization
SBSC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY NAGER (PRESIDENT/CEO)
(617) 244-3322
Entity
Organization
Contact information
Practice address
246 WALNUT ST, SUITE 104, NEWTON, MA 02460-1689
(617) 244-3322
(617) 244-1827
Mailing address
246 WALNUT ST, SUITE 104, NEWTON, MA 02460-1689
(617) 244-3322
(617) 581-6040
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
163WP0808X
Psychiatric/Mental Health Registered Nurse
—
—
2084P0800X
Psychiatry Physician
—
—
363L00000X
Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9765051
—
MA
01
—
DF1155
RR MEDICARE
MA
01
—
M19119
BLUE CROSS AND BLUE SHIEL
MA
Enumeration date
05/16/2006
Last updated
04/14/2011
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