Eavan S Durwin, PHD

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

9784 Issued in MA

Practice address

319 Peakham Rd
Sudbury, MA 01776-2757

Phone

(978) 493-2848

NPI assigned

Aug 28, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Eavan Miles-Mason, PHD LLC

  • Clinical Child & Adolescent Psychologist
  • Concord, MA
  • NPI 1518575786
  NPD (past) Authorized official

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

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1245588904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 PEAKHAM RD",
            "city": "SUDBURY",
            "state": "MA",
            "postal_code": "017762757",
            "telephone_number": "978-493-2848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 PEAKHAM RD",
            "city": "SUDBURY",
            "state": "MA",
            "postal_code": "017762757",
            "telephone_number": "978-493-2848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURWIN",
        "first_name": "EAVAN",
        "middle_name": "S",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-28",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MA",
            "license": "9784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr Jennifer Lees LLC
• Dr Peter E Yaffe PC
• Drumlin Develeopment, LLC
• Ronnie Du, DMD
• William Edward Duncan
• Janice Marie Eardley
• Eastern Massachusetts Personalized Behavioral Health
• Erin Elizabeth Egan, DPT
• Elizabeth Ressler-Craig, LLC
• Maria Luisa Elizondo, DMD

• Clinical Child & Adolescent Psychologist in Sudbury, MA
• Providers in Sudbury, MA by specialty
• Clinical Child & Adolescent Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.