Active NPI
Marciana J Didomenico, PHD
- Psychologist
- Winchester, MA
National Provider Identifier
1114410826
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 10825
- Practice address
- 611 Main St Ste 302D
Winchester, MA 01890-2051 - Phone
- (978) 790-3300
- NPI assigned
- Jun 8, 2018
- Last updated
- Dec 20, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 10825 | MA | Primary |
Addresses
Primary practice location
611 Main St Ste 302D
Winchester, MA 01890-2051
Mailing address
611 Main St Ste 302D
Winchester, MA 01890-2051
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walk With Me Psychology, LLC | Psychologist | Current | Accepting new patients |
Locations
611 Main St
Ste 302D
Winchester, MA 01890
Phone (978) 790-3300
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671494400000",
"number": "1114410826",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 MAIN ST STE 302D",
"city": "WINCHESTER",
"state": "MA",
"postal_code": "018902051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 MAIN ST STE 302D",
"city": "WINCHESTER",
"state": "MA",
"postal_code": "018902051",
"telephone_number": "978-790-3300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIDOMENICO",
"first_name": "MARCIANA",
"middle_name": "J",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-08",
"last_updated": "2022-12-20",
"certification_date": "2022-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "10825",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winchester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.