Active NPI
Angela Taveira-Dick, PH.D.
- Clinical Psychologist
- Bedford, MA
National Provider Identifier
1053725523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0810005004
- Practice address
- 200 Springs Rd
Bedford, MA 01730-1114 - Phone
- (781) 687-3415
- NPI assigned
- Jun 12, 2014
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0810005004 | VA | Primary |
Addresses
Primary practice location
200 Springs Rd
Bedford, MA 01730-1114
Mailing address
16 Island Hill Ave
Apt 311
Melrose, MA 02176-6139
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0810005004 | VA | MD | Clinical Psychologist |
| 11105 | MA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405900800000",
"number": "1053725523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 ISLAND HILL AVE",
"address_2": "APT 311",
"city": "MELROSE",
"state": "MA",
"postal_code": "021766139"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 SPRINGS RD",
"city": "BEDFORD",
"state": "MA",
"postal_code": "017301114",
"telephone_number": "781-687-3415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAVEIRA-DICK",
"first_name": "ANGELA",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-12",
"last_updated": "2014-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810005004",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bedford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.