Jean L Smith, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

MA LIC # 2589 Issued in MA

Practice address

11 Homer St
Newton Centre, MA 02459-1510

Phone

(617) 558-8880

NPI assigned

Jan 26, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225184039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "398 LOWELL AVE",
            "city": "NEWTONVILLE",
            "state": "MA",
            "postal_code": "024602152",
            "telephone_number": "617-558-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 HOMER ST",
            "city": "NEWTON CENTRE",
            "state": "MA",
            "postal_code": "024591510",
            "telephone_number": "617-558-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JEAN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "MA LIC # 2589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0509175",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laurie Bingham Sherwood, M.S.S.A. (M.S.W.)
• Sarah D Shih, D.D.S., M.S., D.M.SC
• Yuri Shkuratov
• David Shulman, DMD
• Anthony W Sisti, MSPT
• Alan D. Solowsky, D.D.S.
• Roger W Spingarn, MD
• Allyn St. Lifer, LICSW
• Ann B Stambler, LICSW
• Morris J.L. Stambler, M.D.

• Clinical Psychologist in Newton Centre, MA
• Providers in Newton Centre, MA by specialty
• Clinical Psychologist in Massachusetts

• 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; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.