Active NPI
Elizabeth Gibson, PSY.D.
- Clinical Psychologist
- West Boylston, MA
National Provider Identifier
1275633760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 5096
- Practice address
- 45 Sterling St
Suite 35
West Boylston, MA 01583-1200 - Phone
- (508) 754-6444
- Fax
- (978) 464-5838
- NPI assigned
- Sep 24, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 5096 | MA | Primary |
Addresses
Primary practice location
45 Sterling St
Suite 35
West Boylston, MA 01583-1200
Mailing address
45 Sterling St
Suite 35
West Boylston, MA 01583-1200
Phone (508) 754-6444
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 |
|---|---|---|---|
| 5096 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275633760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45 STERLING ST",
"address_2": "SUITE 35",
"city": "WEST BOYLSTON",
"state": "MA",
"postal_code": "015831200",
"telephone_number": "508-754-6444",
"fax_number": "978-464-5838"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 STERLING ST",
"address_2": "SUITE 35",
"city": "WEST BOYLSTON",
"state": "MA",
"postal_code": "015831200",
"telephone_number": "508-754-6444",
"fax_number": "978-464-5838"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "5096",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Boylston, MA
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.