TRIAD ADOLESCENT SERVICES (NPI# 1316368749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316368749 |
| Entity Type | Organization |
| Organization Name | TRIAD ADOLESCENT SERVICES |
| Practice Address |
363 Mass Ave Suite 204 Lexington MA 02420 |
| Practice Telephone | 7818644814 |
| Mailing Telephone | 7818644814 |
| Enumeration Date | 2014-01-03 |
| Last Update Date | 2014-01-03 |
| Authorized Official Name | DR. GILLIAN CAROL GALEN (CLINICAL DIRECTOR) |
| Authorized Official Telephone | 6172909432 |
| Authorized Official Credential | PSYD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
2353 | MA | Behavioral Health & Social Service Providers |
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
9159 | MA | Behavioral Health & Social Service Providers |
| Street Address |
363 MASS AVE SUITE 204 |
| City | LEXINGTON |
| State | MA |
| Zip Code | 02420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568958643 | Kristen Gargiulo | Physical Therapist | 57 Bedord Street, Ste 202, Lexington, MA 02420 | 2018-07-02 |
| 1902311616 | Lindsey Nicole Wilcox | Physical Therapist | 57 Bedford St Ste 202, Lexington, MA 02420 | 2017-12-05 |
| 1629590443 | Jeffrey Phillip Winer | Psychologist | 57 Bedford St Ste 230, Lexington, MA 02420 | 2017-07-13 |
| 1235678178 | Rebecca Munini | Counselor | 76 Bedford Street, Suite 12, Office 1, Lexington, MA 02420 | 2017-02-13 |
| 1700332376 | Aretha Cohen | Speech-Language Pathologist | 840 Emerson Gardens Road, Excel Center, Lexington, MA 02420 | 2016-09-01 |
| 1710387915 | Niravkumar Patel | Internal Medicine | 4 Hadley Rd, Lexington, MA 02420 | 2014-08-26 |
| 1447698063 | Emily Flier Matteodo | Psychiatry & Neurology | 35 Bedford Street, Suite #6, Lexington, MA 02420 | 2013-06-05 |
| 1780941914 | Varun Kapur | Surgery | 33 York St, Lexington, MA 02420 | 2012-04-12 |
| 1992091433 | Karolyn Mary Franz | Acupuncturist | 238 Bedford St Ste 5, Lexington, MA 02420 | 2011-06-23 |
| 1205004645 | Rachel A Hartstein | Acupuncturist | Sage Community Acupuncture, 62 Massachusetts Avenue, Lexington, MA 02420 | 2008-02-20 |
| Find all providers in zip 02420 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144565888 | Nicole Ann Begg | Psychologist | 740 S Limestone L404, Lexington, KY 40536-1059 | 2012-12-06 |
| 1720224397 | Tracy H Heibeck | Psychologist | 46 Meriam St, Lexington, MA 02420-3620 | 2009-01-01 |
| 1093966624 | Kerrie Jongeneelen | Psychologist | 19 Muzzey St Ste 202a, Lexington, MA 02421-5211 | 2008-10-01 |
| 1013455823 | Tyler Smith Buckhout | Psychologist | 186 Bedford St, Lexington, MA 02420-4436 | 2017-02-01 |
| 1558503227 | Dianna Elizabeth Hartley | Psychologist | 1025 Dove Run Rd, Suite 204, Lexington, KY 40502-3588 | 2009-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518575786 | Eavan Miles-mason, Phd, LLC | Psychologist | 319 Peakham Rd, Sudbury, MA 01776-2757 | 2020-07-14 |
| 1184247132 | Lauren R Blakely | Psychologist | 96 Fairbanks Ave, Wellesley, MA 02481-5256 | 2020-05-26 |
| 1881220986 | Katharine Dunson Oconnell | Psychologist | 144 Forest St, Wellesley Hills, MA 02481-6832 | 2020-03-20 |
| 1710457577 | Karla Lizbet Rivas | Psychologist | 44 Mansfield St, Allston, MA 02134 | 2018-12-04 |
| 1497230684 | Marisa Katherine Glynn | Psychologist | 35 Edgar Avenue, Somerville, MA 02145 | 2018-10-03 |
| 1043706419 | Jessica Shepley | Psychologist | 72 Fox Hill Rd, Bernardston, MA 01337-9586 | 2018-07-09 |
| 1548755176 | Elizabeth F Clark | Psychologist | 16 Gleasondale Rd, Stow, MA 01775-1465 | 2018-06-26 |
| 1528552619 | Heather Duckworth Smith | Psychologist | 5 Seal Cove Ln, Hingham, MA 02043-1050 | 2018-06-21 |
| 1467946251 | Olivia Moorehead-slaughter | Psychologist | 171 Goddard Ave, Brookline, MA 02445-7412 | 2018-06-15 |
| 1710479522 | David Arnold | Psychologist | 35 Hop Brook Rd, Amherst, MA 01002-2771 | 2018-06-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.