Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Chmc Otolaryngologic Foundation, Inc

Organization Clinical Psychologist · NPI 1124118229

Chmc Otolaryngologic Foundation, Inc is a Clinical Psychologist in Boston, Massachusetts. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
6
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

300 Longwood Ave
Boston, MA 02115-5724
Phone: (617) 355-6460
Fax: (617) 730-0611
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Otolaryngology Physician (primary) Taxonomy 207Y00000X
Clinical Psychologist Taxonomy 103TC0700X
Pediatric Otolaryngology Physician Taxonomy 207YP0228X
Audiologist Taxonomy 231H00000X
Speech-Language Pathologist Taxonomy 235Z00000X
Surgical Physician Assistant Taxonomy 363AS0400X

Record details

NPI number1124118229
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kathleen Hickey — Provider Enrollment Manager · (617) 355-4956
NPI enumeratedOctober 13, 2006
Last updated in NPPESDecember 11, 2025
Certification dateDecember 11, 2025
Mailing addressPo Box 4162, Woburn, MA 01888-4162

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