Great Blue Heron Psychiatry PLLC
Psychiatry & Neurology, Psychiatry in Wellesley, Massachusetts
1558261149- Practice location
- 148 Linden St Ste 208, Wellesley, MA 02482-7916
- Phone
- 781-218-9248
- Fax
- 781-208-8363
- Last updated
- November 9, 2026
Great Blue Heron Psychiatry PLLC is a healthcare organization based in Wellesley, MA. Great Blue Heron Psychiatry PLLC practices in Wellesley, MA. The NPI Number for Great Blue Heron Psychiatry PLLC is 1558261149. The current practice location address for Great Blue Heron Psychiatry PLLC is 148 Linden St Ste 208, Wellesley, MA 02482-7916 and can be reached out via phone at 781-218-9248 and via fax at 781-208-8363.
Provider Profile Details
- NPI Number
- 1558261149
- Provider Name
- Great Blue Heron Psychiatry PLLC
- Provider Entity Type
- Organization
- Address
- 148 Linden St Ste 208, Wellesley, MA 02482-7916
- Phone Number
- 781-218-9248
- Fax Number
- 781-208-8363
- Primary Taxonomy
- Psychiatry & Neurology, Psychiatry · 2084P0800X
- Organization Subpart
- No
- Authorized Official
- Jennie Davidow, MD · Managing Member · 781-218-9248
- Provider Enumeration Date
- November 9, 2026
- Last Update Date
- November 9, 2026
- Certification Date
- November 8, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 148 Linden St Ste 208
Wellesley, MA 02482-7916 - City
- Wellesley
- State
- Massachusetts
- Zip
- 02482-7916
- Phone Number
- 781-218-9248
- Fax Number
- 781-208-8363
Provider Business Mailing Address Details
- Address
- 148 Linden St Ste 208
Wellesley, MA 02482-7916 - City
- Wellesley
- State
- MA
- Zip
- 02482-7916
- Phone Number
- 781-218-9248
- Fax Number
- 781-208-8363
License Information
- Taxonomy
- Psychiatry & Neurology, Psychiatry · 2084P0800X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Great Blue Heron Psychiatry PLLC?
The NPI number of Great Blue Heron Psychiatry PLLC is 1558261149. It was assigned on November 9, 2026 and is currently active in the NPPES registry.
What is the specialty of Great Blue Heron Psychiatry PLLC?
Great Blue Heron Psychiatry PLLC is registered under the primary taxonomy Psychiatry & Neurology, Psychiatry (code 2084P0800X).
Where does Great Blue Heron Psychiatry PLLC practice?
The practice location is 148 Linden St Ste 208, Wellesley, MA 02482-7916. The office can be reached at 781-218-9248 (phone) or 781-208-8363 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1558261149 directly on the NPPES registry website.