Stephanie A Adler, PHD
Individual provider Active NPI Health Service Psychologist · Brookline, MA
NPI 1174698369 · NPPES record last updated Apr 12, 2011
Key facts
- NPI
- 1174698369
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Health Service Psychologist 103TH0100X
- License
- 2496 (MA)
- Practice address
- 1093 Beacon St
Suite 403
Brookline, MA 02446-5695 - Phone
- (617) 731-8007
- NPI assigned
- Nov 22, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
- Opted out of Medicare
- Yes, effective Sep 28, 2015 through Sep 28, 2027
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2496 | MA | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2496 | MA | |
| Health Service Psychologist | 103TH0100X | 2496 | MA | Yes |
Addresses
Primary practice location
1093 Beacon St
Suite 403
Brookline, MA 02446-5695
Mailing address
213 Jackson St
Newton, MA 02459
Phone (617) 731-8007
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0509817 | Medicaid | MA |
Other names
- Stephanie Adler
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All providers in Brookline, MA · Health Service Psychologist in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 12, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.