Dr. Bruce W Shackleton, EDD
Psychologist, Clinical in Wayland, Massachusetts
1750474383- Practice location
- 35 Main Street #3, Wayland, MA 01778
- Phone
- 508-655-6322
- Fax
- 508-655-9793
- Last updated
- February 26, 2010
Bruce Warner Shackleton is a Psychologist, Clinical based in Wayland, MA. Bruce Warner Shackleton practices in Wayland, MA and has the professional credentials of EDD. The NPI Number for Bruce Warner Shackleton is 1750474383 and holds a License No. 2621 (MA). The current practice location address for Bruce Warner Shackleton is 35 Main Street #3, Wayland, MA 01778 and can be reached out via phone at 508-655-6322 and via fax at 508-655-9793.
Provider Profile Details
- NPI Number
- 1750474383
- Provider Name
- Bruce Warner Shackleton
- Credential
- EDD
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 35 Main Street #3, Wayland, MA 01778
- Phone Number
- 508-655-6322
- Fax Number
- 508-655-9793
- Primary Taxonomy
- Psychologist, Clinical · 103TC0700X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- October 2, 2006
- Last Update Date
- February 26, 2010
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 35 Main Street #3
Wayland, MA 01778 - City
- Wayland
- State
- Massachusetts
- Zip
- 01778
- Phone Number
- 508-655-6322
- Fax Number
- 508-655-9793
Provider Business Mailing Address Details
- Address
- Post Office Box 5232
Wayland, MA 01778 - City
- Wayland
- State
- MA
- Zip
- 01778
- Phone Number
- 508-655-6322
- Fax Number
- 508-655-9793
License Information
- License Number (1)
- 2621
- License State (1)
- MA
- Taxonomy (1)
- Psychologist, Clinical · 103TC0700X · Primary
- License Number (2)
- 2621
- License State (2)
- MA
- Taxonomy (2)
- Psychologist · 103T00000X
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Psychologist, Clinical providers near Wayland, MA
View all Psychologist, Clinical providers in Wayland →- Alethea Desrosiers, PHDPsychologist, Clinical · NPI 1104440932
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- Dr. Barry E Foster, PSYDPsychologist, Clinical · NPI 1851445407
- Dr. Diane Ray, PHDPsychologist, Clinical · NPI 1922080324
- Dr. Elizabeth T Slater, PHDPsychologist, Clinical · NPI 1598819732
- Dr. Judith P Leavitt, EDDPsychologist, Clinical · NPI 1619041621
Frequently Asked Questions
What is the NPI number of Dr. Bruce W Shackleton, EDD?
The NPI number of Dr. Bruce W Shackleton, EDD is 1750474383. It was assigned on October 2, 2006 and is currently active in the NPPES registry.
What is the specialty of Dr. Bruce W Shackleton, EDD?
Dr. Bruce W Shackleton, EDD is registered under the primary taxonomy Psychologist, Clinical (code 103TC0700X), licensed in MA under license number 2621.
Where does Dr. Bruce W Shackleton, EDD practice?
The practice location is 35 Main Street #3, Wayland, MA 01778. The office can be reached at 508-655-6322 (phone) or 508-655-9793 (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 1750474383 directly on the NPPES registry website.