Active NPI
Elise Cohen
- Psychologist
- Quincy, MA
National Provider Identifier
1003470626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 859 Willard St
Quincy, MA 02169-7482 - Phone
- (703) 615-0212
- NPI assigned
- Apr 29, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
859 Willard St
Quincy, MA 02169-7482
Mailing address
21050 41St Ave Apt 5C
Bayside, NY 11361-1916
Phone (703) 615-0212
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 17, 2025 through Apr 17, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560211200000",
"number": "1003470626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21050 41ST AVE APT 5C",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "113611916",
"telephone_number": "703-615-0212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "859 WILLARD ST",
"city": "QUINCY",
"state": "MA",
"postal_code": "021697482",
"telephone_number": "703-615-0212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COHEN",
"first_name": "ELISE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-29",
"last_updated": "2019-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Quincy, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.