Organization Active NPI

Gestalt Institute of New England Inc

  • Psychologist
  • Somerville, MA
National Provider Identifier
1023155306
Registry record updated Oct 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
GESTALT INSTITUTE OF NEW ENGLAND INC
Practice address
240 A Elm St.
Journey Women
Somerville, MA 02144
Phone
(617) 764-2009
NPI assigned
Jan 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2008

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

Authorized official

Name
Mr. Lee Geltman, MA IN CLINICAL PSYCHNPI 1891849345
Title
President
Phone
(617) 764-2009

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X

Addresses

Primary practice location

240 A Elm St.
Journey Women
Somerville, MA 02144

Mailing address

80 Winslow Avenue
Unit 2E
Somerville, MA 02144-2556
Phone (617) 764-2009

Other identifiers 2

IdentifierTypeStateIssuer
GEW10063OtherMABLUE CROSS BLUE SHIELD
717059OtherMATUFTS HEALTH PLAN MEDICAR

National Provider Directory

National Provider Directory

Locations

240 Elm St
#A
Somerville, MA 02144
Phone (617) 764-2009

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224806400000",
    "number": "1023155306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 WINSLOW AVENUE",
            "address_2": "UNIT 2E",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021442556",
            "telephone_number": "617-764-2009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 A ELM ST.",
            "address_2": "JOURNEY WOMEN",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "02144",
            "telephone_number": "617-764-2009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GESTALT INSTITUTE OF NEW ENGLAND INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2008-10-24",
        "status": "A",
        "authorized_official_last_name": "GELTMAN",
        "authorized_official_first_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-764-2009",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA IN CLINICAL PSYCH"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "GEW10063",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN MEDICAR",
            "identifier": "717059",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.