Individual provider Active NPI

Tracey Lynn Guertin, PH.D., H.S.P.

  • Psychologist
  • West Boylston, MA
National Provider Identifier
1326104126
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
7680 Issued in MA
Practice address
148 Worcester St
West Boylston, MA 01583-1751
Phone
(508) 835-1735
Fax
(508) 835-1736
NPI assigned
Dec 28, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 7680 MA Primary
Cognitive & Behavioral Psychologist 103TB0200X 7680 MA
Clinical Psychologist 103TC0700X 7680 MA
Clinical Child & Adolescent Psychologist 103TC2200X 7680 MA
Family Psychologist 103TF0000X 7680 MA
Health Service Psychologist 103TH0100X 7680 MA

Addresses

Primary practice location

148 Worcester St
West Boylston, MA 01583-1751

Mailing address

148 Worcester St
West Boylston, MA 01583-1751
Phone (508) 835-1735

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
7680MAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Behavioral Health, LLC Cognitive & Behavioral PastSince Apr 10, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1326104126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 WORCESTER ST",
            "city": "WEST BOYLSTON",
            "state": "MA",
            "postal_code": "015831751",
            "telephone_number": "508-835-1735",
            "fax_number": "508-835-1736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 WORCESTER ST",
            "city": "WEST BOYLSTON",
            "state": "MA",
            "postal_code": "015831751",
            "telephone_number": "508-835-1735",
            "fax_number": "508-835-1736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERTIN",
        "first_name": "TRACEY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PH.D., H.S.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "7680",
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MA",
            "license": "7680",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "7680",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MA",
            "license": "7680",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "MA",
            "license": "7680",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "MA",
            "license": "7680",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Boylston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.