NPIMap

Organization Active NPI

Axelrad Psychotherapy LLC

  • Clinical Psychologist
  • Leverett, MA
National Provider Identifier
1073268629
Registry record updated Feb 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
AXELRAD PSYCHOTHERAPY LLC
Practice address
194 Montague Rd
Leverett, MA 01054-9727
Phone
(413) 225-1943
NPI assigned
Feb 12, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2022

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

Authorized official

Name
Jeremy Axelrad, PHDNPI 1619622263
Title
Owner
Phone
(413) 225-1943

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

194 Montague Rd
Leverett, MA 01054-9727

Mailing address

194 Montague Rd
Leverett, MA 01054-9727

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1644624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644624000000",
    "number": "1073268629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 MONTAGUE RD",
            "city": "LEVERETT",
            "state": "MA",
            "postal_code": "010549727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 MONTAGUE RD",
            "city": "LEVERETT",
            "state": "MA",
            "postal_code": "010549727",
            "telephone_number": "413-225-1943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXELRAD PSYCHOTHERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-12",
        "last_updated": "2022-02-12",
        "certification_date": "2022-02-12",
        "status": "A",
        "authorized_official_last_name": "AXELRAD",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "413-225-1943",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leverett, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2022; 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.