Individual provider Active NPI

Andrew Jonah Taytslin, PSY.D.

  • Clinical Psychologist
  • Brookline, MA
National Provider Identifier
1013585116
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS01956 Issued in RI
Practice address
1180 Beacon St Ste 4B
Brookline, MA 02446-3806
Phone
(508) 233-0401
NPI assigned
Jun 15, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY10001156 MA
Clinical Psychologist 103TC0700X PS01956 RI Primary

Addresses

Primary practice location

1180 Beacon St Ste 4B
Brookline, MA 02446-3806

Mailing address

1180 Beacon St Ste 4B
Brookline, MA 02446-3806
Phone (508) 233-0401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY10001156MAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Gershon Psychological Associates, LLC CurrentSince Jun 1, 2021 Accepting new patients
Psychology & Diagnostics, PLLC Clinical Current Accepting new patients

Locations

1180 Beacon St
Ste 4B
Brookline, MA 02446
Phone (617) 277-2449

400 Bald Hill Rd
Ste 530
Warwick, RI 02886
Phone (401) 737-9091

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.andrewtaytslin@151046.advancedmd-direct.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1013585116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 BEACON ST STE 4B",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024463806",
            "telephone_number": "508-233-0401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 BEACON ST STE 4B",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024463806",
            "telephone_number": "508-233-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYTSLIN",
        "first_name": "ANDREW",
        "middle_name": "JONAH",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-15",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "PSY10001156",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "RI",
            "license": "PS01956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.