Blais, Mark Alan
Blais, Mark Alan is an individual health care provider with primary practice located at 55 Fruit St Wrn 1227, Boston MA 02114-2696. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Blais, Mark Alan can be contacted via phone (617) 724-9143.Contact Information
Primary practice address
55 Fruit St Wrn 1227
Boston MA 02114-2696
Phone: (617) 724-9143
Fax: (617) 724-9150
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 6201 | Massachusetts |
Profile Details
| NPI number | 1871583047 |
|---|---|
| LBN Legal business name | Blais, Mark Alan |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 27th, 2005 |
| Last updated | Jul 13th, 2026 - about 3 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871583047 | NPPES |
| Massachusetts | MEDICAID | 0522198 | |
| Massachusetts | Other | 723413 | |
| Massachusetts | Other | W05000 |
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