Active NPI
Eileen R Wiznitzer, PSY.D.
- Psychologist
- Belmont, MA
National Provider Identifier
1336217629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 5 Watson Rd
#101
Belmont, MA 02478-3924 - Phone
- (339) 223-6002
- NPI assigned
- Dec 2, 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 4514 | MA | |
| Clinical Psychologist | 103TC0700X | 4514 | MA | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | |||
| Health Service Psychologist | 103TH0100X | |||
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
5 Watson Rd
#101
Belmont, MA 02478-3924
Mailing address
38 Wachusett Dr
Lexington, MA 02421-6913
Phone (339) 223-6002
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0519979 | Medicaid | MA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4514 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685491200000",
"number": "1336217629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38 WACHUSETT DR",
"city": "LEXINGTON",
"state": "MA",
"postal_code": "024216913",
"telephone_number": "339-223-6002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 WATSON RD",
"address_2": "#101",
"city": "BELMONT",
"state": "MA",
"postal_code": "024783924",
"telephone_number": "339-223-6002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIZNITZER",
"first_name": "EILEEN",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-02",
"last_updated": "2023-05-31",
"certification_date": "2023-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "4514",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "4514",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TH0100X",
"taxonomy_group": "",
"desc": "Psychologist, Health Service",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0519979",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Belmont, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.