Active NPI
Stephani Synn, PSY.D.
- Psychologist
- Boston, MA
National Provider Identifier
1275183394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 11649
- Practice address
- 53 Parker Hill Ave
Boston, MA 02120-3225 - Phone
- (617) 278-4122
- NPI assigned
- Sep 19, 2019
- Last updated
- Dec 10, 2021
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 11649 | MA | Primary |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 11649 | MA | |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
53 Parker Hill Ave
Boston, MA 02120-3225
Mailing address
53 Parker Hill Ave
Boston, MA 02120-3225
Phone (617) 278-4122
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | drive |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11649 | MA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Judge Baker Children's Center | Current | Accepting new patients |
Locations
53 Parker Hill Ave
Roxbury Xing, MA 02120
Phone (617) 232-8390
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Adolescent and Children Mental Health Clinic/Center
- Boston, MA
- NPI 1629559059
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639094400000",
"number": "1275183394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "53 PARKER HILL AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "021203225",
"telephone_number": "617-278-4122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "53 PARKER HILL AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "021203225",
"telephone_number": "617-278-4122"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SYNN",
"first_name": "STEPHANI",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-19",
"last_updated": "2021-12-10",
"certification_date": "2021-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "11649",
"primary": true
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "MA",
"license": "11649",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "drive",
"affiliation": "N",
"address_1": "53 Parker Hill Ave",
"city": "Boston",
"state": "MA",
"country_code": "US",
"postal_code": "021203225",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
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 Dec 10, 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.