Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | PSY 7196 | MA |
N | 103TC0700X | Clinical Psychologist | PSY 7196 | MA |
Y | 102L00000X | Psychologist | 7196 | MA |
Y | 103T00000X | Psychologist | 7196 | MA |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 7196 | MA |
N | 103TA0700X | Adult Development & Aging Psychologist | 7196 | MA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 7196 | MA |
N | 103G00000X | Clinical Psychologist | 7196 | MA |
N | 103TC0700X | Clinical Psychologist | 7196 | MA |
N | 103TC1900X | Counseling Psychologist | 7196 | MA |
N | 103TM1800X | Intellectual & Developmental Disabilities | 7196 | MA |
NPI | 1376652552 |
---|---|
Provider Name | Dr. Winfred J Hentschel |
First Address | Cambridge, MA 02138-4832 |
Second Address | Cambridge, MA 02138-4832 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 27/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0526398 | MASS HEALTH (01) | MA |
W05763 | BCBS (01) | MA |