Active NPI
Jennifer Taub, PH.D.
- Clinical Psychologist
- Jamaica Plain, MA
National Provider Identifier
1316170939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 8049
- Practice address
- 65 Cornwall St Unit 310
Jamaica Plain, MA 02130-2698 - Phone
- (857) 205-6778
- NPI assigned
- Aug 30, 2009
- Last updated
- Aug 30, 2009
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 8049 | MA | Primary |
Addresses
Primary practice location
65 Cornwall St Unit 310
Jamaica Plain, MA 02130-2698
Mailing address
65 Cornwall St Unit 310
Jamaica Plain, MA 02130-2698
Phone (857) 205-6778
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jun 18, 2019 through Jun 18, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8049 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251590400000",
"number": "1316170939",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65 CORNWALL ST UNIT 310",
"city": "JAMAICA PLAIN",
"state": "MA",
"postal_code": "021302698",
"telephone_number": "857-205-6778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 CORNWALL ST UNIT 310",
"city": "JAMAICA PLAIN",
"state": "MA",
"postal_code": "021302698",
"telephone_number": "857-205-6778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAUB",
"first_name": "JENNIFER",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-08-30",
"last_updated": "2009-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "8049",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamaica Plain, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2009; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.