Individual provider Active NPI

Katherine Lou, PSY.D.

  • Psychologist
  • Boston, MA
National Provider Identifier
1285085159
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
10493 Issued in MA
Practice address
75 Arlington St FL 5
Boston, MA 02116-3936
Phone
(617) 366-2550
Fax
(617) 340-3733
NPI assigned
Jun 22, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Development & Aging Psychologist 103TA0700X 10493 MA
Psychologist 103T00000X 10493 MA Primary

Addresses

Primary practice location

75 Arlington St FL 5
Boston, MA 02116-3936

Mailing address

8709 Bray Vista Way
Elk Grove, CA 95624-1713
Phone (617) 366-2550

Other identifiers 1

IdentifierTypeStateIssuer
110119105AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161209000327 MA Practitioner - Clinical Psychologist 0244510253 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

75 Arlington St
FL 5
Boston, MA 02116-3936
Phone (617) 366-2550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10493MAMDGerontology Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Relatespace LLC CurrentSince May 26, 2020 Accepting new patients
Relatespace Psychotherapy PC PastSince Jan 15, 2023 Accepting new patients

Locations

75 Arlington St
Fl 5
Boston, MA 02116
Phone (617) 366-2550

Organizations & group practices 2

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": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1285085159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8709 BRAY VISTA WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956241713",
            "telephone_number": "617-366-2550",
            "fax_number": "617-340-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 ARLINGTON ST FL 5",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021163936",
            "telephone_number": "617-366-2550",
            "fax_number": "617-340-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOU",
        "first_name": "KATHERINE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-22",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "MA",
            "license": "10493",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "10493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110119105A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.