Active NPI
Jennifer Obrien, PH.D.
- Psychologist
- Cambridge, MA
National Provider Identifier
1326607680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 10227
- Practice address
- 25 Carleton St
Cambridge, MA 02142-1323 - Phone
- (617) 253-2916
- Fax
- (617) 253-0162
- NPI assigned
- Jun 11, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 10227 | MA | Primary |
Addresses
Primary practice location
25 Carleton St
Cambridge, MA 02142-1323
Mailing address
909 South St
Roslindale, MA 02131-2411
Phone (413) 519-7725
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10227 | Medicaid | MA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | obri@med.mit.edu | Health Information Exchange (HIE) |
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10227 | MA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560211200000",
"number": "1326607680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "909 SOUTH ST",
"city": "ROSLINDALE",
"state": "MA",
"postal_code": "021312411",
"telephone_number": "413-519-7725"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 CARLETON ST",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021421323",
"telephone_number": "617-253-2916",
"fax_number": "617-253-0162"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBRIEN",
"first_name": "JENNIFER",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-11",
"last_updated": "2019-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "10227",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10227",
"state": "MA"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "obri@med.mit.edu",
"affiliation": "N",
"endpointDescription": "Email address",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "25 Carleton St",
"city": "Cambridge",
"state": "MA",
"country_code": "US",
"postal_code": "021421323",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.