Basic Information
| Provider Information | |||||||||
| NPI: | 1235280389 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | O'CALLAGHAN | ||||||||
| FirstName: | CLARE | ||||||||
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| Credential: | RN.C.S., ED.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 42 OLD QUARRY DR | ||||||||
| Address2: | |||||||||
| City: | WEYMOUTH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021883867 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7813372118 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1601 WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021181951 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174252000 | ||||||||
| FaxNumber: | 6174252043 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/16/2007 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103G00000X | 2024 | MA | X | Behavioral Health & Social Service Providers | Clinical Neuropsychologist | 163WP0808X | 121276 | MA | X | Nursing Service Providers | Registered Nurse | Psych/Mental Health |
No ID Information.