Kathryn Mary Roeder, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

11012 Issued in MA

Practice address

729 Boylston St FL 5
Boston, MA 02116-2639

Phone

(617) 800-9610

Fax

(866) 496-3029

NPI assigned

Aug 15, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Boston Child Study Center Psychology Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Los Angeles, CA
  • NPI 1972239242
  NPD
• Boston Child Study Center Los Angeles Licensed Clinical Social Work SE

  • Psychologist
  • Los Angeles, CA
  • NPI 1992273338
  NPD (past)

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

{
    "created_epoch": "1376524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625184000000",
    "number": "1306279146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 BOYLSTON ST FL 5",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021162639",
            "telephone_number": "617-800-9610",
            "fax_number": "866-496-3029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 BOYLSTON ST FL 5",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021162639",
            "telephone_number": "617-800-9610",
            "fax_number": "866-496-3029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEDER",
        "first_name": "KATHRYN",
        "middle_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-15",
        "last_updated": "2021-07-02",
        "certification_date": "2021-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "11012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Finora Mary Rodriques
• Stephanie Rodway, PT, DPT
• Alexa Roe, LICSW
• Eugene Roe, MD
• Nancy Roe, OTR/L
• John Roefaro, PHARMD
• Michael H. Roehrl, MD, PHD
• Lizabeth Roemer, PH.D.
• Coco Jeong En Roening, DDS
• Joshua L Roffman, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2021; 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.