Active NPI
Nancy Stephanie Mroczek, PHD
- Clinical Neuropsychologist
- Boston, MA
National Provider Identifier
1336204999
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 1972
- Practice address
- 183 Marlborough St
Boston, MA 02116 - Phone
- (617) 266-9268
- NPI assigned
- Dec 26, 2006
- 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 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 1972 | MA | Primary |
| Adult Development & Aging Psychologist | 103TA0700X | 1972 | MA | |
| Cognitive & Behavioral Psychologist | 103TB0200X | 1972 | MA | |
| Health Service Psychologist | 103TH0100X | 1972 | MA | |
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | 1972 | MA | |
| Psychologist | 103T00000X | 1972 | MA | |
| Group Psychotherapy Psychologist | 103TP2701X | 1972 | MA | |
| Rehabilitation Psychologist | 103TR0400X | 1972 | MA |
Addresses
Primary practice location
183 Marlborough St
Boston, MA 02116
Mailing address
183 Marlborough St
Boston, MA 02116
Phone (617) 266-9268
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1972 | MA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285200000000",
"number": "1336204999",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "183 MARLBOROUGH ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "02116",
"telephone_number": "617-266-9268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "183 MARLBOROUGH ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "02116",
"telephone_number": "617-266-9268"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MROCZEK",
"first_name": "NANCY",
"middle_name": "STEPHANIE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-26",
"last_updated": "2010-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "MA",
"license": "1972",
"primary": true
},
{
"code": "103TA0700X",
"taxonomy_group": "",
"desc": "Psychologist, Adult Development & Aging",
"state": "MA",
"license": "1972",
"primary": false
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "MA",
"license": "1972",
"primary": false
},
{
"code": "103TH0100X",
"taxonomy_group": "",
"desc": "Psychologist, Health Service",
"state": "MA",
"license": "1972",
"primary": false
},
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": "MA",
"license": "1972",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "1972",
"primary": false
},
{
"code": "103TP2701X",
"taxonomy_group": "",
"desc": "Psychologist, Group Psychotherapy",
"state": "MA",
"license": "1972",
"primary": false
},
{
"code": "103TR0400X",
"taxonomy_group": "",
"desc": "Psychologist, Rehabilitation",
"state": "MA",
"license": "1972",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.