Active NPI
Edmund Conrad Neuhaus, PHD
- Clinical Psychologist
- Auburndale, MA
National Provider Identifier
1093761066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 4826
- Practice address
- 275 Grove St
Suite 2-400
Auburndale, MA 02466-2272 - Phone
- (617) 663-4948
- Fax
- (617) 663-4801
- NPI assigned
- May 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 4826 | MA | Primary |
Addresses
Primary practice location
275 Grove St
Suite 2-400
Auburndale, MA 02466-2272
Mailing address
275 Grove St
Suite 2-400
Auburndale, MA 02466-2272
Phone (617) 663-4948
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| W04593 | Other | MA | BCBS |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251763200000",
"number": "1093761066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "275 GROVE ST",
"address_2": "SUITE 2-400",
"city": "AUBURNDALE",
"state": "MA",
"postal_code": "024662272",
"telephone_number": "617-663-4948",
"fax_number": "617-663-4801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 GROVE ST",
"address_2": "SUITE 2-400",
"city": "AUBURNDALE",
"state": "MA",
"postal_code": "024662272",
"telephone_number": "617-663-4948",
"fax_number": "617-663-4801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEUHAUS",
"first_name": "EDMUND",
"middle_name": "CONRAD",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-25",
"last_updated": "2009-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "4826",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "W04593",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Auburndale, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.