Organization Active NPI

Acton Psychological Associates LLC

  • Clinical Psychologist
  • Acton, MA
National Provider Identifier
1013419381
Registry record updated Mar 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
7814 Issued in MA
Legal business name
ACTON PSYCHOLOGICAL ASSOCIATES LLC
Practice address
532 Great Rd
Acton, MA 01720-3415
Phone
(508) 785-5518
NPI assigned
Mar 2, 2018
Last updated
Mar 2, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Eleanor Kent Fulton, PSY.D.NPI 1285006734
Title
Director/Owner
Phone
(508) 785-5518

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 7814 MA Primary

Addresses

Primary practice location

532 Great Rd
Acton, MA 01720-3415

Mailing address

74 Meadowview Rd
Groton, MA 01450-1051
Phone (508) 785-5518

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180417000136 MA Part B Supplier - Clinic/Group Practice 7214290741 Receives reassigned benefits from 1 practitioner
Practice locations: Acton, MA

National Provider Directory

National Provider Directory

Locations

532 Great Rd
Acton, MA 01720
Phone (508) 785-5518

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1519948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519948800000",
    "number": "1013419381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 MEADOWVIEW RD",
            "city": "GROTON",
            "state": "MA",
            "postal_code": "014501051",
            "telephone_number": "508-785-5518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "532 GREAT RD",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017203415",
            "telephone_number": "508-785-5518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTON PSYCHOLOGICAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-02",
        "last_updated": "2018-03-02",
        "status": "A",
        "authorized_official_last_name": "FULTON",
        "authorized_official_first_name": "ELEANOR",
        "authorized_official_middle_name": "KENT",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "508-785-5518",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "7814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Acton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.