Individual provider Active NPI

Sandra Elizabeth Kent, PSY.D.

  • Clinical Psychologist
  • West Boylston, MA
National Provider Identifier
1144281734
Registry record updated Jan 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4763 Issued in MA
Practice address
45 Sterling St
Suite 23
West Boylston, MA 01583-1200
Phone
(774) 261-8530
Fax
(508) 829-9158
NPI assigned
Mar 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 4763 MA Primary

Addresses

Primary practice location

45 Sterling St
Suite 23
West Boylston, MA 01583-1200

Mailing address

45 Sterling St
Suite 23
West Boylston, MA 01583-1200
Phone (774) 261-8530

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
I20120223000681 MA Practitioner - Clinical Psychologist 9133387053 Practice locations: West Boylston, MA; Worcester, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

45 Sterling St
Suite 23
West Boylston, MA 01583-1268
Phone (774) 261-8530

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4763MAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420416000000",
    "number": "1144281734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 STERLING ST",
            "address_2": "SUITE 23",
            "city": "WEST BOYLSTON",
            "state": "MA",
            "postal_code": "015831200",
            "telephone_number": "774-261-8530",
            "fax_number": "508-829-9158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 STERLING ST",
            "address_2": "SUITE 23",
            "city": "WEST BOYLSTON",
            "state": "MA",
            "postal_code": "015831200",
            "telephone_number": "774-261-8530",
            "fax_number": "508-829-9158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENT",
        "first_name": "SANDRA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2015-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "4763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Boylston, MA

Sources for this page

Verify at the official NPI Registry.