Active NPI
Nancy Ruth Cetlin, EDD
- Clinical Psychologist
- Boston, MA
National Provider Identifier
1235104050
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3514
- Practice address
- 264 Beacon St
Fourth Floor
Boston, MA 02116 - Phone
- (617) 267-5433
- Fax
- (617) 782-6764
- NPI assigned
- Feb 23, 2006
- 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 | 3514 | MA | Primary |
| Clinical Psychologist | 103TC0700X | 6301002901 | MI |
Addresses
Primary practice location
264 Beacon St
Fourth Floor
Boston, MA 02116
Mailing address
141 Brooks St
Unit 1
Brighton, MA 02135
Phone (617) 254-0284
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0001020601 | Other | MANAGED HEALTH NETWORK | |
| VD6841 | Other | EMPIRE BCBS | |
| 6883946 | Other | VALUE/OPTIONS | |
| A002908 | Other | VAL/H | |
| 0012255000 | Other | AETNA | |
| W03627 | Other | MA | BLUE CROSS |
| 739159 | Other | TUFTS HEALTH PLAN | |
| A002908 | Other | VALUE |
Other names 1
- Mrs. Nancy Cetlin Wilton
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 |
|---|---|---|---|
| 6301002901 | MI | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Commonwealth Psychology Associates | Clinical | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1235104050",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "141 BROOKS ST",
"address_2": "UNIT 1",
"city": "BRIGHTON",
"state": "MA",
"postal_code": "02135",
"telephone_number": "617-254-0284",
"fax_number": "617-782-6764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "264 BEACON ST",
"address_2": "FOURTH FLOOR",
"city": "BOSTON",
"state": "MA",
"postal_code": "02116",
"telephone_number": "617-267-5433",
"fax_number": "617-782-6764"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CETLIN",
"first_name": "NANCY",
"middle_name": "RUTH",
"name_prefix": "Ms.",
"credential": "EDD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-23",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "3514",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301002901",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MANAGED HEALTH NETWORK",
"identifier": "0001020601",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BCBS",
"identifier": "VD6841",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE/OPTIONS",
"identifier": "6883946",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VAL/H",
"identifier": "A002908",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "0012255000",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "W03627",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH PLAN",
"identifier": "739159",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE",
"identifier": "A002908",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "NANCY",
"last_name": "WILTON",
"middle_name": "CETLIN",
"prefix": "MRS.",
"credential": "EDD",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.