Active NPI
Michelle Mund, PSY.D.
- Clinical Psychologist
- Waltham, MA
National Provider Identifier
1144553959
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 9448
- Practice address
- 40 Crescent St
Suite 101
Waltham, MA 02453-4313 - Phone
- (917) 208-5003
- NPI assigned
- Sep 11, 2009
- Last updated
- Jun 26, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 9448 | MA | Primary |
Addresses
Primary practice location
40 Crescent St
Suite 101
Waltham, MA 02453-4313
Mailing address
40 Crescent St
Suite 101
Waltham, MA 02453-4313
Phone (917) 208-5003
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 19, 2025 through Mar 19, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9448 | MA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372204800000",
"number": "1144553959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 CRESCENT ST",
"address_2": "SUITE 101",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024534313",
"telephone_number": "917-208-5003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 CRESCENT ST",
"address_2": "SUITE 101",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024534313",
"telephone_number": "917-208-5003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUND",
"first_name": "MICHELLE",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-09-11",
"last_updated": "2013-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "9448",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jun 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.