Individual provider Active NPI

Pamela Alessandra Raskin, PH.D.

  • Clinical Psychologist
  • Braintree, MA
National Provider Identifier
1154450468
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2625 Issued in MA
Practice address
985 Washington St
Braintree, MA 02184-5434
Phone
(781) 848-5674
NPI assigned
Mar 4, 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
Clinical Psychologist 103TC0700X 2625 MA Primary

Addresses

Primary practice location

985 Washington St
Braintree, MA 02184-5434

Mailing address

37 Walker St
Cambridge, MA 02138-2412
Phone (617) 876-2482

Other identifiers 1

IdentifierTypeStateIssuer
RA WO2-691OtherMAPROVIDER NUMBER

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2625MAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1172966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154450468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 WALKER ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021382412",
            "telephone_number": "617-876-2482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "985 WASHINGTON ST",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021845434",
            "telephone_number": "781-848-5674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASKIN",
        "first_name": "PAMELA",
        "middle_name": "ALESSANDRA",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "2625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "RA WO2-691",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Braintree, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.