Basic Information
| Provider Information | |||||||||
| NPI: | 1972513737 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARRINGTON | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 725 NORTH STREET | ||||||||
| Address2: | DEPT OF PSYCHIATRY PCOT | ||||||||
| City: | PITTSFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4134472352 | ||||||||
| FaxNumber: | 4134472176 | ||||||||
| Practice Location | |||||||||
| Address1: | 725 NORTH STREET | ||||||||
| Address2: | DEPT OF PSYCHIATRY PCOT | ||||||||
| City: | PITTSFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4134472352 | ||||||||
| FaxNumber: | 4134472176 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/08/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TB0200X | 7043 | MA | Y | Behavioral Health & Social Service Providers | Psychologist | Cognitive & Behavioral |
ID Information
| ID | Type | State | Issuer | Description | 0522236 | 05 | MA | MEDICAID |