Organization Active NPI

Amethyst Integration LLC

  • Clinical Psychologist
  • Medford, MA
National Provider Identifier
1326807249
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
AMETHYST INTEGRATION LLC
Practice address
10 Navarro Circle
Medford, MA 02155
Phone
(617) 286-2816
NPI assigned
Mar 14, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Authorized official

Name
Dr. Elizabeth Barch, PSYDNPI 1679914147
Title
Clinical Psychologist
Phone
(617) 286-2816

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

10 Navarro Circle
Medford, MA 02155

Mailing address

51 Pleasant St # 258
Malden, MA 02148-4904
Phone (617) 286-2816

Other identifiers 1

IdentifierTypeStateIssuer
1679914147MedicaidMA

Other names 1

  • Amethyst Integration Other name

National Provider Directory

National Provider Directory

Locations

51 Pleasant St
Malden, MA 02148
Phone (617) 420-2296

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1710374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710374400000",
    "number": "1326807249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 PLEASANT ST # 258",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021484904",
            "telephone_number": "617-286-2816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 NAVARRO CIRCLE",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "02155",
            "telephone_number": "617-286-2816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMETHYST INTEGRATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-14",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-12",
        "status": "A",
        "authorized_official_last_name": "BARCH",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "617-286-2816",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679914147",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amethyst Integration",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Medford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; 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.