Active NPI
Virginia K Donovan, PH.D.
- Psychologist
- Somerville, MA
National Provider Identifier
1174565501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1800
- Practice address
- 61 Roseland St
Somerville, MA 02143-3524 - Phone
- (617) 354-6270
- Fax
- (617) 354-6275
- NPI assigned
- Jun 11, 2006
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1800 | MA | Primary |
Addresses
Primary practice location
61 Roseland St
Somerville, MA 02143-3524
Mailing address
61 Roseland St
Somerville, MA 02143-3524
Phone (617) 354-6270
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1800 | MA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200355200000",
"number": "1174565501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "61 ROSELAND ST",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021433524",
"telephone_number": "617-354-6270",
"fax_number": "617-354-6275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "61 ROSELAND ST",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021433524",
"telephone_number": "617-354-6270",
"fax_number": "617-354-6275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONOVAN",
"first_name": "VIRGINIA",
"middle_name": "K",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-11",
"last_updated": "2008-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "1800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Somerville, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.