NPIMap

Organization Active NPI

Concord Comprehensive Neuropsychological Services

  • Clinical Neuropsychologist
  • Concord, MA
National Provider Identifier
1023769296
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Legal business name
CONCORD COMPREHENSIVE NEUROPSYCHOLOGICAL SERVICES
Practice address
86 Baker Avenue Ext Ste 301
Concord, MA 01742-2132
Phone
(978) 341-4992
NPI assigned
Jan 10, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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

Authorized official

Name
Kathryn Connolly, PHD
Title
Neuropsychologist, Co-Owner
Phone
(978) 341-4992

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X Primary

Addresses

Primary practice location

86 Baker Avenue Ext Ste 301
Concord, MA 01742-2132

Mailing address

86 Baker Avenue Ext Ste 301
Concord, MA 01742-2132
Phone (978) 341-4992

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1641772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641772800000",
    "number": "1023769296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 BAKER AVENUE EXT STE 301",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017422132",
            "telephone_number": "978-341-4992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 BAKER AVENUE EXT STE 301",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017422132",
            "telephone_number": "978-341-4992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCORD COMPREHENSIVE NEUROPSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-10",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-05",
        "status": "A",
        "authorized_official_last_name": "CONNOLLY",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "NEUROPSYCHOLOGIST, CO-OWNER",
        "authorized_official_telephone_number": "978-341-4992",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.

Verify at the official NPI Registry.