Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Meditelecare of Massachusetts, PLLC

Organization Clinical Psychologist · NPI 1003496506

Meditelecare of Massachusetts, PLLC is a Clinical Psychologist in Boston, Massachusetts. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
6
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

84 State St
Boston, MA 02109-2202
Phone: (860) 788-6404
Fax: (860) 829-0495
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X
Clinical Social Worker Taxonomy 1041C0700X
Psychiatry Physician Taxonomy 2084P0800X
Geriatric Psychiatry Physician Taxonomy 2084P0805X
Nurse Practitioner Taxonomy 363L00000X
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X

Record details

NPI number1003496506
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Andrea Godfrey — Credentialing & Enrollment Manager · (860) 398-6441
NPI enumeratedApril 9, 2021
Last updated in NPPESMay 5, 2025
Certification dateMay 5, 2025
Mailing addressPo Box 1595, Middletown, CT 06457-8095

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