Active NPI
Charles A Dooley, PH.D.
- Psychologist
- Salem, MA
National Provider Identifier
1295912582
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 08824
- Practice address
- 81 Highland Ave
Salem, MA 01970-2714 - Phone
- (978) 354-2705
- NPI assigned
- Jan 29, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 08824 | MA | Primary |
Addresses
Primary practice location
81 Highland Ave
Salem, MA 01970-2714
Mailing address
15 Chester PL
Somerville, MA 02144-2822
Phone (617) 764-2402
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA, CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161207001425 | MA | Practitioner - Clinical Psychologist | 1355621467 | Practice locations: Longmeadow, MA |
| I20210224001585 | CT | Practitioner - Clinical Psychologist | 1355621467 | Practice locations: Hartford, CT |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
171 Dwight Rd
Suite 102a
Longmeadow, MA 01106-1768
Phone (617) 939-3943
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08824 | MA | MD | Psychologist |
| 8824 | MA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201564800000",
"number": "1295912582",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 CHESTER PL",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021442822",
"telephone_number": "617-764-2402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "81 HIGHLAND AVE",
"city": "SALEM",
"state": "MA",
"postal_code": "019702714",
"telephone_number": "978-354-2705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOOLEY",
"first_name": "CHARLES",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-01-29",
"last_updated": "2008-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "08824",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.