Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 10947 | MA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 10947 | MA |
Y | 103G00000X | Clinical Psychologist | 10947 | MA |
Y | 103TC0700X | Clinical Psychologist | 10947 | MA |
N | 103TP2701X | Group Psychotherapist | 10947 | MA |
NPI | 1629479829 |
---|---|
Provider Name | Sean Joseph Mcglew |
First Address | Belmont, MA 02478-4066 |
Second Address | Belmont, MA 02478-4066 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2014 |
Last Update Date | 02/03/2020 |