Individual provider Active NPI

Michelle Kovacs, PHD

  • Clinical Psychologist
  • Brockton, MA
National Provider Identifier
1043733413
Registry record updated Jun 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS01628 Issued in RI
Practice address
940 Belmont St
Brockton, MA 02301
Phone
(813) 400-5961
NPI assigned
Jul 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS01628 RI Primary

Addresses

Primary practice location

940 Belmont St
Brockton, MA 02301

Mailing address

940 Belmont St
Brockton, MA 02301
Phone (813) 400-5961

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
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528934400000",
    "number": "1043733413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 BELMONT ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "02301",
            "telephone_number": "813-400-5961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 BELMONT ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "02301",
            "telephone_number": "813-400-5961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVACS",
        "first_name": "MICHELLE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-18",
        "last_updated": "2018-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "RI",
            "license": "PS01628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.