Individual provider Active NPI

Caitlin McMahon Nichols, PHD

  • Counseling Psychologist
  • Milford, MA
National Provider Identifier
1164749388
Registry record updated Jul 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Practice address
321 Fortune Blvd
Milford, MA 01757-1750
Phone
(508) 478-0207
Fax
(508) 634-6984
NPI assigned
Apr 28, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X Primary

Addresses

Primary practice location

321 Fortune Blvd
Milford, MA 01757-1750

Mailing address

321 Fortune Blvd
Milford, MA 01757-1750
Phone (508) 478-0207

Other identifiers 3

IdentifierTypeStateIssuer
110026265EMedicaidMA
M18708OtherMABLUE CROSS OF MASS
685661OtherMATUFTS

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

NPI Registry JSON

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

{
    "created_epoch": "1272412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374710400000",
    "number": "1164749388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 FORTUNE BLVD",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017571750",
            "telephone_number": "508-478-0207",
            "fax_number": "508-634-6984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 FORTUNE BLVD",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017571750",
            "telephone_number": "508-478-0207",
            "fax_number": "508-634-6984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "CAITLIN",
        "middle_name": "MCMAHON",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-28",
        "last_updated": "2013-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110026265E",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF MASS",
            "identifier": "M18708",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "685661",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2013; 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.