Active NPI
Elaine Veracruz, PSY.D.
- Clinical Psychologist
- Weymouth, MA
National Provider Identifier
1063783421
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 10441
- Practice address
- 169 Libbey Pkwy
Second Floor
Weymouth, MA 02189-3101 - Phone
- (781) 551-0999
- Fax
- (781) 551-3396
- NPI assigned
- Jan 17, 2012
- Last updated
- Sep 22, 2016
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Mental Health Counselor | 101YM0800X | |||
| Clinical Psychologist | 103TC0700X | 10441 | MA | Primary |
Addresses
Primary practice location
169 Libbey Pkwy
Second Floor
Weymouth, MA 02189-3101
Mailing address
169 Libbey Pkwy
Second Floor
Weymouth, MA 02189-3101
Phone (781) 551-0999
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 7, 2024 through Mar 7, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10441 | MA | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brookline Psychologist PLLC | Mental Health | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Beacon Therapy Group
- Clinical Psychologist
- Brookline, MA
- NPI 1730735408
Mental Health
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474502400000",
"number": "1063783421",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "169 LIBBEY PKWY",
"address_2": "SECOND FLOOR",
"city": "WEYMOUTH",
"state": "MA",
"postal_code": "021893101",
"telephone_number": "781-551-0999",
"fax_number": "781-551-3396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "169 LIBBEY PKWY",
"address_2": "SECOND FLOOR",
"city": "WEYMOUTH",
"state": "MA",
"postal_code": "021893101",
"telephone_number": "781-551-0999",
"fax_number": "781-551-3396"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERACRUZ",
"first_name": "ELAINE",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-01-17",
"last_updated": "2016-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "10441",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Weymouth, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.