NPIMap

Individual provider Active NPI

Nancy Leontine Woolbert, MA PSYCHOANALYSIS

  • Psychoanalyst
  • Waltham, MA
National Provider Identifier
1124385513
Registry record updated Apr 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychoanalystTaxonomy code 102L00000X
Practice address
87 Plympton St
Waltham, MA 02451-0737
Phone
(781) 894-0311
NPI assigned
Apr 23, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychoanalyst 102L00000X Primary
Psychoanalyst 102L00000X NOT LICENSED MA

Addresses

Primary practice location

87 Plympton St
Waltham, MA 02451-0737

Mailing address

87 Plympton St
Waltham, MA 02451-0737
Phone (781) 894-0311

Other names 1

  • Ms. Nancy Tina Woolbert Professional name

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

State licenses

LicenseStateTypeSpecialty
NOT LICENSEDMAMDPsychoanalyst

NPI Registry JSON

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

{
    "created_epoch": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335139200000",
    "number": "1124385513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 PLYMPTON ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024510737",
            "telephone_number": "781-894-0311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 PLYMPTON ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024510737",
            "telephone_number": "781-894-0311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOLBERT",
        "first_name": "NANCY",
        "middle_name": "LEONTINE",
        "name_prefix": "Ms.",
        "credential": "MA  PSYCHOANALYSIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-23",
        "last_updated": "2012-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "MA",
            "license": "NOT LICENSED",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NANCY",
            "last_name": "WOOLBERT",
            "middle_name": "TINA",
            "prefix": "MS.",
            "credential": "MA PSYCHOANALYSIS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2012; 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.