Active NPI
Meghan Patrice Fennessy, M.ED, LABA, BCBA
- Behavior Analyst
- Weymouth, MA
National Provider Identifier
1336509769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1084005
- Practice address
- 1290 Washington St
Weymouth, MA 02189-2317 - Phone
- (617) 861-1763
- NPI assigned
- Feb 26, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 437 | MA | |
| Behavior Analyst | 103K00000X | 1084005 | MA | Primary |
Addresses
Primary practice location
1290 Washington St
Weymouth, MA 02189-2317
Mailing address
1290 Washington St
Weymouth, MA 02189-2317
Phone (617) 861-1763
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
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1084005 | MA | MD | Behavioral Analyst |
| 437 | MA | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456444800000",
"number": "1336509769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1290 WASHINGTON ST",
"city": "WEYMOUTH",
"state": "MA",
"postal_code": "021892317",
"telephone_number": "617-861-1763"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1290 WASHINGTON ST",
"city": "WEYMOUTH",
"state": "MA",
"postal_code": "021892317",
"telephone_number": "617-861-1763"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FENNESSY",
"first_name": "MEGHAN",
"middle_name": "PATRICE",
"name_prefix": "Mrs.",
"credential": "M.ED, LABA, BCBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-02-26",
"last_updated": "2016-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MA",
"license": "437",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MA",
"license": "1084005",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Weymouth, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.