INTEGRATED CENTER FOR CHILD DEVELOPMENT (ICCD PARTNERS) NPI 1003011388

Clinical Neuropsychologist in Canton, MA

NPI 1003011388 Organization Clinical Neuropsychologist

About INTEGRATED CENTER FOR CHILD DEVELOPMENT (ICCD PARTNERS)

Integrated Center For Child Development (iccd Partners) is a provider established in Canton, Massachusetts specializing in clinical neuropsychologist. The NPI number of Integrated Center For Child Development (iccd Partners) is 1003011388 and was assigned on June 2007. The practitioner's primary taxonomy code is 103G00000X. The provider is registered as an organization and their NPI record was last updated 14 years ago. Integrated Center For Child Development (iccd Partners) operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's is doing business as Integrated Center For Child Development. The authorized official of this NPI record is Joseph Moldover Psy.d (Co Director)

NPI

1003011388

Provider NameINTEGRATED CENTER FOR CHILD DEVELOPMENT (ICCD PARTNERS)
Provider Location Address340 TURNPIKE ST SUITE 11A CANTON, MA 02021
Provider Mailing Address340 TURNPIKE ST SUITE 11A CANTON, MA 02021
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameINTEGRATED CENTER FOR CHILD DEVELOPMENT
Other Name TypeDoing Business As (3)
Enumeration Date06-18-2007
Last Update Date08-29-2007


Primary Taxonomy

Taxonomy Code103G00000X
ClassificationClinical Neuropsychologist
TypeBehavioral Health & Social Service Providers
Taxonomy DescriptionA clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.

Business Address

INTEGRATED CENTER FOR CHILD DEVELOPMENT
340 TURNPIKE ST
SUITE 11A
CANTON, MA
ZIP 02021
Phone: (617) 641-0900
Fax: (617) 641-0930

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Mailing Address

INTEGRATED CENTER FOR CHILD DEVELOPMENT
340 TURNPIKE ST
SUITE 11A
CANTON, MA
ZIP 02021
Phone: (617) 641-0900
Fax: (617) 641-0930



Authorized Official

Authorized Official Name JOSEPH MOLDOVER PSY.D
Authorized Official TitleCO DIRECTOR
Authorized Official Phone(617) 641-0900

Group Taxonomy


193200000X MULTI-SPECIALTY GROUP - This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1063487346 AMY M COUGHLIN M.S., CCC-SLP
Individual
Speech-Language Pathologist340 TURNPIKE ST SUITE 1-3A
CANTON, MA 02021
(781) 619-1500
1285898106DR. REBECCA J EDDY MUCCILLI PSY.D.
Individual
Psychologist340 TURNPIKE ST 1-3A
CANTON, MA 02021
(781) 619-1500
1013166743 KATIA FREDRIKSEN PSY.D
Individual
Clinical Neuropsychologist340 TURNPIKE ST
CANTON, MA 02021
(781) 619-1500
1265681993 JESSICA MCQUOID PH.D
Individual
Clinical Neuropsychologist340 TURNPIKE ST
CANTON, MA 02021
(781) 619-1500
1235365156ICCD PARTNERS, LLP
Organization
Speech-Language Pathologist340 TURNPIKE ST
CANTON, MA 02021
(781) 619-1500
1417289489ICCD PARTNERS, LLP
Organization
Clinic/Center (Developmental Disabilities)340 TURNPIKE ST
CANTON, MA 02021
(781) 619-1500
1043529498ICCD PARTNERS
Organization
Pediatrics (Developmental - Behavioral Pediatrics)340 TURNPIKE ST
CANTON, MA 02021
(781) 619-1500
1295031557 SQIRE PAIGE
Individual
Counselor (Mental Health)340 TURNPIKE ST
CANTON, MA 02021
(781) 619-1500
1205181872 KERRY ELLEN MCCOLGAN M.A., CCC-SLP
Individual
Speech-Language Pathologist340 TURNPIKE ST SUITE 1-3A
CANTON, MA 02021
(781) 619-1500
1366677460 ZOE K OKOLIE
Individual
Social Worker (Clinical)340 TURNPIKE ST SUITE 1
CANTON, MA 02021
(781) 619-1523
1952646895 MEGHAN DRISCOLL PSY.D
Individual
Clinical Neuropsychologist340 TURNPIKE ST
CANTON, MA 02021
(781) 619-1500
1578708988 NICOLE ZWIEP OT
Individual
Occupational Therapist340 TURNPIKE ST SUITE 1-3A
CANTON, MA 02021
(781) 619-1500
1104261635 CONSTANCE KUMIKO WAUTHIER MSOT, OTR/L
Individual
Occupational Therapist340 TURNPIKE ST
CANTON, MA 02021
(781) 619-1500
1720401979INTEGRATED CENTER FOR CHILD DEVELOPMENT
Organization
Specialist340 TURNPIKE ST
CANTON, MA 02021
(781) 619-1500
1558766543 BONNIE NGUYEN
Individual
Speech-Language Pathologist340 TURNPIKE ST
CANTON, MA 02021
(781) 619-1500
1104292903 KATHLEEN HOLMES CCC-SLP
Individual
Speech-Language Pathologist340 TURNPIKE ST SUITE1-3A
CANTON, MA 02021
(781) 619-1500
1043620800MRS. JESSICA ALVES HANNA OTR/L
Individual
Specialist340 TURNPIKE ST
CANTON, MA 02021
(781) 619-1581
1760825459MS. CAROLINE J BRINKERT M.S., CCC-SLP
Individual
Speech-Language Pathologist340 TURNPIKE ST
CANTON, MA 02021
(781) 619-1500
1033652912 SARAH ERVIN MS,OTR/L
Individual
Specialist340 TURNPIKE ST
CANTON, MA 02021
(781) 619-1581
1326540725 KAYLA BRUCCOLERI OTR/L
Individual
Occupational Therapist340 TURNPIKE ST
CANTON, MA 02021
(201) 407-1072

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.