Active NPI
John J. Gorvin, PSY.D.
- Clinical Psychologist
- Wakefield, MA
National Provider Identifier
1205846599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6347
- Practice address
- 7 Lincoln St
Suite 304
Wakefield, MA 01880-3021 - Phone
- (781) 246-4555
- NPI assigned
- Aug 9, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6347 | MA | Primary |
Addresses
Primary practice location
7 Lincoln St
Suite 304
Wakefield, MA 01880-3021
Mailing address
7 Lincoln St
Suite 304
Wakefield, MA 01880-3021
Phone (781) 246-4555
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1041330 | Other | MA | BEACON HEALTH |
| 102732 | Other | NY | EMPIRE BLUE CROSS |
| 012426 | Other | MA | VALUE OPTIONS |
| 0526649 | Medicaid | MA | |
| 1899384 | Other | MA | MBHP |
| W05072 | Other | MA | BLUE CROSS |
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 |
|---|---|---|---|
| 6347 | MA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205846599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 LINCOLN ST",
"address_2": "SUITE 304",
"city": "WAKEFIELD",
"state": "MA",
"postal_code": "018803021",
"telephone_number": "781-246-4555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 LINCOLN ST",
"address_2": "SUITE 304",
"city": "WAKEFIELD",
"state": "MA",
"postal_code": "018803021",
"telephone_number": "781-246-4555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORVIN",
"first_name": "JOHN",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "6347",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEACON HEALTH",
"identifier": "1041330",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BLUE CROSS",
"identifier": "102732",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "012426",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0526649",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MBHP",
"identifier": "1899384",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "W05072",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wakefield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.