Individual provider Active NPI

Pamela Grace Devaney, PSY.D.

  • Psychologist
  • Andover, MA
National Provider Identifier
1295771533
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
7935 Issued in MA
Practice address
63 Park St
Suite 15
Andover, MA 01810-3662
Phone
(978) 474-5004
Fax
(978) 474-5004
NPI assigned
Jun 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 7935 MA
Psychologist 103T00000X 7935 MA Primary
Adult Development & Aging Psychologist 103TA0700X 7935 MA
Clinical Psychologist 103TC0700X 7935 MA
Clinical Child & Adolescent Psychologist 103TC2200X 7935 MA
Health Service Psychologist 103TH0100X 7935 MA

Addresses

Primary practice location

63 Park St
Suite 15
Andover, MA 01810-3662

Mailing address

511 E Broadway
Haverhill, MA 01830-2401
Phone (978) 373-0786

Other identifiers 2

IdentifierTypeStateIssuer
0501221MedicaidMA
W06131OtherMABLIE CROSS BLUE SHIELD

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
I20110426000465 MA Practitioner - Clinical Psychologist 9537344163 Practice locations: Haverhill, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

511 E Broadway
Haverhill, MA 01830-2401
Phone (978) 852-2508

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7935MAMDClinical Neuropsychologist

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1295771533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 E BROADWAY",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018302401",
            "telephone_number": "978-373-0786",
            "fax_number": "978-373-0778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 PARK ST",
            "address_2": "SUITE 15",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018103662",
            "telephone_number": "978-474-5004",
            "fax_number": "978-474-5004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVANEY",
        "first_name": "PAMELA",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MA",
            "license": "7935",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "7935",
            "primary": true
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "MA",
            "license": "7935",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "7935",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MA",
            "license": "7935",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "MA",
            "license": "7935",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0501221",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLIE CROSS BLUE SHIELD",
            "identifier": "W06131",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, MA

Sources for this page

Verify at the official NPI Registry.