Active NPI
Kathleen Mooney
- Behavior Analyst
- Newton, MA
National Provider Identifier
1013432400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-21-54050
- Practice address
- 109 Oak St
Newton, MA 02464-1492 - Phone
- (617) 658-5611
- NPI assigned
- Aug 7, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-21-54050 | MA | Primary |
Addresses
Primary practice location
109 Oak St
Newton, MA 02464-1492
Mailing address
523 E 78TH St Apt 3F
New York, NY 10075-1164
Phone (203) 598-2890
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| U4385410904 | Other | CT | CIGNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652918400000",
"number": "1013432400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "523 E 78TH ST APT 3F",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100751164",
"telephone_number": "203-598-2890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 OAK ST",
"city": "NEWTON",
"state": "MA",
"postal_code": "024641492",
"telephone_number": "617-658-5611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOONEY",
"first_name": "KATHLEEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-07",
"last_updated": "2022-05-19",
"certification_date": "2022-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MA",
"license": "1-21-54050",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "U4385410904",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.