Provider Demographics
NPI:1730256421
Name:DOSCHER, KEVIN PAUL (PSYD)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:PAUL
Last Name:DOSCHER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:447 WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-7432
Mailing Address - Country:US
Mailing Address - Phone:413-499-3153
Mailing Address - Fax:
Practice Address - Street 1:333 EAST ST
Practice Address - Street 2:BRIEN CENTER
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-5312
Practice Address - Country:US
Practice Address - Phone:413-499-0412
Practice Address - Fax:413-499-0979
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA717101YM0800X
MA7248103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA31658OtherHEALTH NEW ENGLAND
MAW50271Medicare ID - Type UnspecifiedMEDICARE