Tahira Lodge, PHD

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

7139 Issued in MA

Practice address

49 Robinwood Ave
Jamaica Plain, MA 02130-2156

Phone

(617) 390-1220

Fax

(617) 390-1595

NPI assigned

Feb 11, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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.

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": "1613001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1245822113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 WILLOWWOOD ST",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021244030",
            "telephone_number": "617-510-5957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 ROBINWOOD AVE",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302156",
            "telephone_number": "617-390-1220",
            "fax_number": "617-390-1595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LODGE",
        "first_name": "TAHIRA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-11",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "7139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Coquinco Llamas, PA
• Dalia Julia Llera, ED.D.
• Christopher Lloyd, M.ED.
• Veronica Lloyd
• Claire Lockard, PHARMD
• Jessica Carmer Loftus, MSW
• Yelana N Loiselle
• Ling-Ling Lok, MD
• William Hughes Londergan
• Jessica Alyse London-Rand, LICSW

• Mental Health Counselor in Jamaica Plain, MA
• Providers in Jamaica Plain, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.