Organization Active NPI

Integrated Assessment Services, LLC

  • Clinical Neuropsychologist
  • Cambridge, MA
National Provider Identifier
1053747659
Registry record updated Sep 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
7822 Issued in MA
Legal business name
INTEGRATED ASSESSMENT SERVICES, LLC
Practice address
1753 Massachusetts Ave
Cambridge, MA 02140-2231
Phone
(617) 661-1100
Fax
(617) 661-1101
NPI assigned
Sep 16, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2013

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

Authorized official

Name
Dr. Melinda Eileen Kulish, PH.D.
Title
President
Phone
(617) 661-1100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X 7822 MA Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 7822 MA

Addresses

Primary practice location

1753 Massachusetts Ave
Cambridge, MA 02140-2231

Mailing address

1753 Massachusetts Ave
Cambridge, MA 02140-2231
Phone (617) 661-1100

National Provider Directory

National Provider Directory

Locations

1753 Massachusetts Ave
Cambridge, MA 02140
Phone (617) 661-7516

NPI Registry JSON

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

{
    "created_epoch": "1379289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379289600000",
    "number": "1053747659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1753 MASSACHUSETTS AVE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021402231",
            "telephone_number": "617-661-1100",
            "fax_number": "617-661-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1753 MASSACHUSETTS AVE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021402231",
            "telephone_number": "617-661-1100",
            "fax_number": "617-661-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED ASSESSMENT SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-16",
        "last_updated": "2013-09-16",
        "status": "A",
        "authorized_official_last_name": "KULISH",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_middle_name": "EILEEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-661-1100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "MA",
            "license": "7822",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "7822",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2013; 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.