Active NPI
Autumn Lynn Porubsky, PSYD
- Clinical Psychologist
- Springfield, MA
National Provider Identifier
1164664157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 11002
- Practice address
- 300 Carew Street
Ste 2
Springfield, MA 01104-2146 - Phone
- (413) 794-9816
- Fax
- (413) 794-4945
- NPI assigned
- Apr 6, 2009
- 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 | 11002 | MA | Primary |
Addresses
Primary practice location
300 Carew Street
Ste 2
Springfield, MA 01104-2146
Mailing address
280 Chestnut St FL 2
Springfield, MA 01199-1001
Phone (413) 794-5700
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11002 | MA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1238976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554768000000",
"number": "1164664157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "280 CHESTNUT ST FL 2",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "011991001",
"telephone_number": "413-794-5700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 CAREW STREET",
"address_2": "STE 2",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "011042146",
"telephone_number": "413-794-9816",
"fax_number": "413-794-4945"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORUBSKY",
"first_name": "AUTUMN",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-06",
"last_updated": "2019-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "11002",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.