NPIMap

Organization Active NPI

Azimuth Psychological

  • Clinical Psychologist
  • Cambridge, MA
National Provider Identifier
1316387020
Registry record updated Jun 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
9574 Issued in MA
Legal business name
AZIMUTH PSYCHOLOGICAL
Practice address
875 Massachusetts Ave
#21
Cambridge, MA 02139-3067
Phone
(617) 207-4053
NPI assigned
Jun 26, 2013
Last updated
Jun 26, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2013

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

Authorized official

Name
Janna Koretz, PSYDNPI 1447532031
Title
Partner
Phone
(617) 207-4053

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 9574 MA Primary

Addresses

Primary practice location

875 Massachusetts Ave
#21
Cambridge, MA 02139-3067

Mailing address

875 Massachusetts Ave
#21
Cambridge, MA 02139-3067
Phone (617) 207-4053

National Provider Directory

National Provider Directory

Locations

875 Massachusetts Ave
Ste 21
Cambridge, MA 02139
Phone (617) 207-4053

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372204800000",
    "number": "1316387020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 MASSACHUSETTS AVE",
            "address_2": "#21",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393067",
            "telephone_number": "617-207-4053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 MASSACHUSETTS AVE",
            "address_2": "#21",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393067",
            "telephone_number": "617-207-4053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZIMUTH PSYCHOLOGICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-26",
        "last_updated": "2013-06-26",
        "status": "A",
        "authorized_official_last_name": "KORETZ",
        "authorized_official_first_name": "JANNA",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "617-207-4053",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "9574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2013; 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.