Active NPI
Carin Janet Roberge, PSY.D.
- Clinical Psychologist
- Arlington, MA
National Provider Identifier
1215066519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY6521
- Practice address
- 259 Massachusetts Ave
Arlington, MA 02474-8406 - Phone
- (781) 646-6697
- NPI assigned
- Mar 4, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY6521 | MA | Primary |
Addresses
Primary practice location
259 Massachusetts Ave
Arlington, MA 02474-8406
Mailing address
259 Massachusetts Ave
Arlington, MA 02474-8406
Phone (781) 646-6697
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Y62153 | Other | MA | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 6, 2020 through Nov 6, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY6521 | MA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215066519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "259 MASSACHUSETTS AVE",
"city": "ARLINGTON",
"state": "MA",
"postal_code": "024748406",
"telephone_number": "781-646-6697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "259 MASSACHUSETTS AVE",
"city": "ARLINGTON",
"state": "MA",
"postal_code": "024748406",
"telephone_number": "781-646-6697"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERGE",
"first_name": "CARIN",
"middle_name": "JANET",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "PY6521",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "Y62153",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Arlington, 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.