NPIMap

Individual provider Active NPI

Catherine Brawn Fortier, PH.D.

  • Clinical Neuropsychologist
  • Boston, MA
National Provider Identifier
1063508372
Registry record updated Apr 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
8253 Issued in MA
Practice address
150 S Huntington Ave
VA Boston Healthcare System 182-JP
Boston, MA 02130-4817
Phone
(857) 364-4361
Fax
(857) 364-4544
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 8253 MA Primary
VA Clinic/Center 261QV0200X 8253 MA

Addresses

Primary practice location

150 S Huntington Ave
VA Boston Healthcare System 182-JP
Boston, MA 02130-4817

Mailing address

150 S Huntington Ave
VA Boston Healthcare System 182-JP
Boston, MA 02130-4817
Phone (857) 364-4361

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
8253MAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492041600000",
    "number": "1063508372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 S HUNTINGTON AVE",
            "address_2": "VA BOSTON HEALTHCARE SYSTEM 182-JP",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021304817",
            "telephone_number": "857-364-4361",
            "fax_number": "857-364-4544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S HUNTINGTON AVE",
            "address_2": "VA BOSTON HEALTHCARE SYSTEM 182-JP",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021304817",
            "telephone_number": "857-364-4361",
            "fax_number": "857-364-4544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTIER",
        "first_name": "CATHERINE",
        "middle_name": "BRAWN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2017-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MA",
            "license": "8253",
            "primary": true
        },
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": "MA",
            "license": "8253",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2017; 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.