Active NPI
Clairalice Campini, PHD
- Clinical Psychologist
- Cambridge, MA
National Provider Identifier
1194055038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 10519
- Practice address
- 234 Broadway Ste 2
Cambridge, MA 02139-1947 - Phone
- (617) 758-8485
- NPI assigned
- Dec 26, 2009
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 071.007659 | IL | |
| Clinical Psychologist | 103TC0700X | 10519 | MA | Primary |
Addresses
Primary practice location
234 Broadway Ste 2
Cambridge, MA 02139-1947
Mailing address
130 Winthrop St Apt 1
Medford, MA 02155-4418
Phone (773) 726-2125
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071.007659 | IL | MD | Clinical Psychologist |
| 10519 | MA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1261785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584576000000",
"number": "1194055038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 WINTHROP ST APT 1",
"city": "MEDFORD",
"state": "MA",
"postal_code": "021554418",
"telephone_number": "773-726-2125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "234 BROADWAY STE 2",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021391947",
"telephone_number": "617-758-8485"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPINI",
"first_name": "CLAIRALICE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-12-26",
"last_updated": "2020-03-19",
"certification_date": "2020-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071.007659",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "10519",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.