Robert Michael Childs, PSY.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

7857 Issued in MA

Practice address

120 Garden St
Cambridge, MA 02138-6723

Phone

(617) 354-1614

NPI assigned

Jan 10, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2017 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225187875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 GARDEN ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021386723",
            "telephone_number": "617-354-1614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 GARDEN ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021386723",
            "telephone_number": "617-354-1614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDS",
        "first_name": "ROBERT",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "7857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "W06199",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tim Bruce Chilcott, R.N.
• Gwendolyn G Child
• Nicole Marie Childers
• Children Services of Roxbury
• Children's Garden Pediatrics, LLC
• Keith Chin
• Michael Thomas Chin, MD PHD
• Andreina Chinea, OT, OTD, OTR/L
• Lin-Ann Ching, MSW
• James Chirackal, DO

• Clinical Psychologist in Cambridge, MA
• Providers in Cambridge, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.