Deville, Douglas M.
Deville, Douglas M. is an sole proprietor health care provider with primary practice located at 729 Boylston St 4Th Floor, Boston MA 02116-2639. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Deville, Douglas M. can be contacted via phone (617) 262-7771.Contact Information
Primary practice address
729 Boylston St 4Th Floor
Boston MA 02116-2639
Phone: (617) 262-7771
Fax: (617) 262-7790
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 6011 | Massachusetts |
Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 600 | New Hampshire |
Profile Details
NPI number | 1902882731 |
---|---|
LBN Legal business name | Deville, Douglas M. |
Credentials | PSY.D. |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Dec 22nd, 2005 |
Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1902882731 | NPPES |
Massachusetts | MEDICAID | DEW04804 | |
Massachusetts | MEDICAID | 80001996 |
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