Active NPI
Aimee Yermish, PSY.D.
- Clinical Psychologist
- Stow, MA
National Provider Identifier
1336473255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 9497
- Practice address
- 14 Red Acre Rd
#3
Stow, MA 01775-1140 - Phone
- (978) 461-4815
- NPI assigned
- Sep 24, 2009
- Last updated
- May 29, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 9497 | MA | Primary |
Addresses
Primary practice location
14 Red Acre Rd
#3
Stow, MA 01775-1140
Mailing address
30 Carriage LN
Stow, MA 01775-1164
Phone (978) 461-4815
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 23, 2021 through Jun 23, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9497 | MA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1253750400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338249600000",
"number": "1336473255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 CARRIAGE LN",
"city": "STOW",
"state": "MA",
"postal_code": "017751164",
"telephone_number": "978-461-4815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 RED ACRE RD",
"address_2": "#3",
"city": "STOW",
"state": "MA",
"postal_code": "017751140",
"telephone_number": "978-461-4815"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YERMISH",
"first_name": "AIMEE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-09-24",
"last_updated": "2012-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "9497",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stow, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.