Active NPI
Chalini Jayasekera, PSYD
- Clinical Psychologist
- Salem, MA
National Provider Identifier
1174924104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 11128
- Practice address
- 55 Highland Ave
Salem, MA 01970-2185 - Phone
- (978) 825-6677
- NPI assigned
- Sep 9, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | S34742724 | MA | |
| Clinical Psychologist | 103TC0700X | 11128 | MA | Primary |
Addresses
Primary practice location
55 Highland Ave
Salem, MA 01970-2185
Mailing address
55 Highland Ave Ste 201
Salem, MA 01970-2100
Phone (978) 825-6677
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 |
|---|---|---|---|
| 11128 | MA | MD | Occupational Therapist |
| S34742724 | MA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571097600000",
"number": "1174924104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 HIGHLAND AVE STE 201",
"city": "SALEM",
"state": "MA",
"postal_code": "019702100",
"telephone_number": "978-825-6677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 HIGHLAND AVE",
"city": "SALEM",
"state": "MA",
"postal_code": "019702185",
"telephone_number": "978-825-6677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAYASEKERA",
"first_name": "CHALINI",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-09-09",
"last_updated": "2019-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MA",
"license": "S34742724",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "11128",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.