Active NPI
Maureen Eleonora McCormick, PH.D.
- Psychologist
- Brookline, MA
National Provider Identifier
1043364045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 7912
- Practice address
- 1330 Beacon St
Ste 203
Brookline, MA 02446-3202 - Phone
- (617) 970-3275
- NPI assigned
- Jan 23, 2007
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 7912 | MA | Primary |
Addresses
Primary practice location
1330 Beacon St
Ste 203
Brookline, MA 02446-3202
Mailing address
PO Box 440315
West Somerville, MA 02144-0027
Phone (617) 970-3275
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2153512 | Other | MA | CIGNA BEHAVIORAL HEALTH |
| 7224414 | Other | MA | AETNA HEALTH CARE |
| 409535 | Other | MA | TUFTS PPO |
| W06095 | Other | MA | BCBS OF MASSACHUSETTS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050308000371 | MA | Practitioner - Clinical Psychologist | 6901850551 | Practice locations: Arlington, MA; Cambridge, MA; Brookline, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1330 Beacon St
Suite 203
Brookline, MA 02446-3202
Phone (617) 970-3275
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7912 | MA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043364045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 440315",
"city": "WEST SOMERVILLE",
"state": "MA",
"postal_code": "021440027",
"telephone_number": "617-970-3275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1330 BEACON ST",
"address_2": "STE 203",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024463202",
"telephone_number": "617-970-3275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCORMICK",
"first_name": "MAUREEN",
"middle_name": "ELEONORA",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "7912",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA BEHAVIORAL HEALTH",
"identifier": "2153512",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HEALTH CARE",
"identifier": "7224414",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS PPO",
"identifier": "409535",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF MASSACHUSETTS",
"identifier": "W06095",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brookline, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.