Individual provider Active NPI

Carol W. Coutu, PH.D.

  • Psychologist
  • Belmont, MA
National Provider Identifier
1124164371
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
4983 Issued in MA
Practice address
113 Belmont St
Belmont, MA 02478-3603
Phone
(617) 489-5333
NPI assigned
Jan 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 4983 MA Primary

Addresses

Primary practice location

113 Belmont St
Belmont, MA 02478-3603

Mailing address

113 Belmont St
Belmont, MA 02478-3603
Phone (617) 489-5333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120320000167 MA Practitioner - Clinical Psychologist 1254591894 Practice locations: Belmont, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

113 Belmont St
Belmont, MA 02478-3603
Phone (617) 489-5333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
4983MAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124164371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 BELMONT ST",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024783603",
            "telephone_number": "617-489-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 BELMONT ST",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024783603",
            "telephone_number": "617-489-5333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUTU",
        "first_name": "CAROL",
        "middle_name": "W.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "4983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belmont, MA

Sources for this page

Verify at the official NPI Registry.