Boston Behavioral Medicine, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

7454 Issued in MA

Legal business name

BOSTON BEHAVIORAL MEDICINE, LLC

Practice address

1371 Beacon St Ste 304
Brookline, MA 02446-4905

Phone

(617) 232-2435

Fax

(617) 232-0078

NPI assigned

Mar 19, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Katharine M Larsson, PHD

Title

Co-Director

Phone

(617) 232-2435

Specialties & licenses 2

Addresses

Other identifiers 11

Locations

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

{
    "created_epoch": "1237420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237420800000",
    "number": "1306087457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1371 BEACON ST STE 304",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024464905",
            "telephone_number": "617-232-2435",
            "fax_number": "617-232-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1371 BEACON ST STE 304",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024464905",
            "telephone_number": "617-232-2435",
            "fax_number": "617-232-0078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON BEHAVIORAL MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-19",
        "last_updated": "2009-03-19",
        "status": "A",
        "authorized_official_last_name": "LARSSON",
        "authorized_official_first_name": "KATHARINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CO-DIRECTOR",
        "authorized_official_telephone_number": "617-232-2435",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "7454",
            "primary": true
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "MA",
            "license": "181401",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH INSURANCE",
            "identifier": "791373",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEGELLAN",
            "identifier": "IP574730",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD LEGACY NUMBER",
            "identifier": "0000PN0601",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD LEGACY NUMBER",
            "identifier": "0000WO6099",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEACON HEALTH STRATEGIES",
            "identifier": "1030430",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1893165",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "LAW51023",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MBHP",
            "identifier": "1093165",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1790817732",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1003850330",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH INSURANCE",
            "identifier": "461385",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Boris Balson, PC
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• Boston Arthritis & Spinal Surgery, P.C.
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• Boston Eye Group, P.C.
• Boston Eye Physicians & Surgeons, P.C.

• Clinical Psychologist in Brookline, MA
• Providers in Brookline, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.