Individual provider Active NPI

Karen Elizabeth Kiley-Brabeck, PHD

  • Psychologist
  • North Reading, MA
National Provider Identifier
1124214309
Registry record updated Dec 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
8705 Issued in MA
Practice address
352 Park Street
Suite 208W
North Reading, MA 01864-1329
Phone
(978) 653-2475
Fax
(978) 207-1006
NPI assigned
Sep 20, 2007
Last updated
Dec 20, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 8705 MA Primary

Addresses

Primary practice location

352 Park Street
Suite 208W
North Reading, MA 01864-1329

Mailing address

352 Park Street
Suite 208W
North Reading, MA 01864-1329
Phone (978) 653-2475

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

State licenses

LicenseStateTypeSpecialty
8705MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Baystate Pediatric Neuropsychology Services, LLC Current Accepting new patients

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": "1190246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482192000000",
    "number": "1124214309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "352 PARK STREET",
            "address_2": "SUITE 208W",
            "city": "NORTH READING",
            "state": "MA",
            "postal_code": "018641329",
            "telephone_number": "978-653-2475",
            "fax_number": "978-207-1006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "352 PARK STREET",
            "address_2": "SUITE 208W",
            "city": "NORTH READING",
            "state": "MA",
            "postal_code": "018641329",
            "telephone_number": "978-653-2475",
            "fax_number": "978-207-1006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILEY-BRABECK",
        "first_name": "KAREN",
        "middle_name": "ELIZABETH",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-20",
        "last_updated": "2016-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "8705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Reading, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2016; 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.