Organization Active NPI

Choate Health Management

  • Clinical Psychologist
  • Lowell, MA
National Provider Identifier
1073674420
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
CHOATE HEALTH MANAGEMENT
Practice address
391 Varnum Ave
Lowell, MA 01854-2119
Phone
(978) 322-5120
NPI assigned
Dec 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Carol A. Porder, M.A.
Title
Director
Phone
(978) 322-5120

Specialties & licenses 1

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

Addresses

Primary practice location

391 Varnum Ave
Lowell, MA 01854-2119

Mailing address

391 Varnum Ave
Lowell, MA 01854-2119
Phone (978) 322-5120

Other identifiers 1

IdentifierTypeStateIssuer
1307126MedicaidMA

National Provider Directory

National Provider Directory
Tax ID family
Arbour Counseling Services Woburn3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073674420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 VARNUM AVE",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018542119",
            "telephone_number": "978-322-5120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 VARNUM AVE",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018542119",
            "telephone_number": "978-322-5120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHOATE HEALTH MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PORDER",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "978-322-5120",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.A."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1307126",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.