Provider Demographics
NPI:1528317583
Name:INSTITUTE FOR SPIRITUAL LIFE AND PSYCHOTHERAPY INC
Entity type:Organization
Organization Name:INSTITUTE FOR SPIRITUAL LIFE AND PSYCHOTHERAPY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:DELAPLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:781-826-0011
Mailing Address - Street 1:PO BOX 2306
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02339-8306
Mailing Address - Country:US
Mailing Address - Phone:781-264-4382
Mailing Address - Fax:781-829-4347
Practice Address - Street 1:17 CHURCH ST
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339-2315
Practice Address - Country:US
Practice Address - Phone:781-264-4382
Practice Address - Fax:781-829-4347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-06
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty