Individual
MARK KINCHLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
154 E CENTRAL ST STE 201, NATICK, MA 01760
(978) 604-5561
(509) 319-3307
Mailing address
154 E CENTRAL ST STE 201, NATICK, MA 01760-3644
(978) 604-5561
(509) 319-3307
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
10081
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1871822098
INDIVIDUAL NPI
MA
05
—
I20150319000938
—
MA
Enumeration date
12/17/2009
Last updated
04/15/2019
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