David Bricklin-Small

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

10819 Issued in MA

Practice address

147 Milk Street
Boston, MA 02109-3200

Phone

(617) 654-7300

Fax

(716) 461-7654

NPI assigned

Oct 1, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• David Marc Small Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1412121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543276800000",
    "number": "1184027401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 MAPLE ST",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "017523200",
            "telephone_number": "541-521-2742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 MILK STREET",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021093200",
            "telephone_number": "617-654-7300",
            "fax_number": "716-461-7654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRICKLIN-SMALL",
        "first_name": "DAVID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-01",
        "last_updated": "2018-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "10819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "SMALL",
            "middle_name": "MARC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christian Brice, CRNA
• Gregory William Brick, MBCHB
• Jessica C. Brick, MD
• Lindsey Brick
• Margaret M. Brickley, NP
• Karen Lee Bride, MD/PHD
• Janet L Brideau, NP
• Bridge Care and Health LLC
• Bridge Over Troubled Waters
• Kelsey Bridges

• Clinical Psychologist in Boston, MA
• Providers in Boston, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2018; 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.