Beth Ann Logan, PHD

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

11765 Issued in MA

Practice address

300 Longwood Ave
Boston, MA 02115-5724

Phone

(617) 355-6000

NPI assigned

Aug 8, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in DE, RI, MA3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Richmond Psychiatry Group Practice

  • Child & Adolescent Psychiatry Physician
  • Boston, MA
  • NPI 1629148036

  Clinical Child & Adolescent

  Medicare reassignment NPD
• Emma Pendleton Bradley Hospital

  • Psychiatric Hospital
  • Riverside, RI
  • NPI 1578768867
  Medicare reassignment NPD
• The Nemours Foundation

  • Multi-Specialty Clinic/Center
  • Wilmington, DE
  • NPI 1366594699
  Medicare reassignment NPD
• Emma Pendleton Bradley Hospital

  • Psychiatry Physician
  • Riverside, RI
  • NPI 1073705943
  NPD
• The Nemours Foundation

  • Children's Hospital
  • Wilmington, DE
  • NPI 1467505073
  NPD
• University of Pittsburgh Physicians

  • Psychiatry Physician
  • Pittsburgh, PA
  • NPI 1215995402

  Clinical Child & Adolescent

  NPD
• University of Pittsburgh Physicians

  • Diagnostic Radiology Physician
  • Pittsburgh, PA
  • NPI 1285692699
  NPD
• University of Pittsburgh Physicians

  • Gastroenterology Physician
  • Pittsburgh, PA
  • NPI 1619935004
  NPD

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

{
    "created_epoch": "1407456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1164831632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "BETH",
        "middle_name": "ANN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-08",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "RI",
            "license": "PS01916",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "DE",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "PA",
            "license": "PS017869",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MA",
            "license": "11765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Loewen
• John I. Loewenstein, M.D.
• Julia Vivian Loewenthal, M.D.
• Brigid Loftus, PA
• Logan Chiropractic Inc
• Claire Logan, M.S. CCC-SLP
• Deirdre E Logan, PHD
• Georgiana Logan, LICSW
• Jesse J Logan, MSN, APRN, FNP-C
• Merranda Logan, M.D.

• Clinical Child & Adolescent Psychologist in Boston, MA
• Providers in Boston, MA by specialty
• Clinical Child & Adolescent Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.