Active NPI
Rachel Crystal, ED.D.
- Counseling Psychologist
- Watertown, MA
National Provider Identifier
1346363603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 6692
- Practice address
- 173 Mount Auburn St
Watertown, MA 02472-4005 - Phone
- (617) 928-0848
- Fax
- (617) 928-0860
- NPI assigned
- Apr 9, 2007
- 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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 6692 | MA | Primary |
Addresses
Primary practice location
173 Mount Auburn St
Watertown, MA 02472-4005
Mailing address
4 Highland Ter
Newtonville, MA 02460-1813
Phone (617) 928-0848
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010229 | Other | MA | HP |
| 767925 | Other | MA | TUFTS HEALTH PLAN |
| 162374 | Other | MA | VALUE OPTIONS |
| W05412 | Other | MA | BLUE CROSS |
| 6279191 | Other | MA | UBH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Sep 20, 2021 through Sep 20, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6692 | MA | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1346363603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 HIGHLAND TER",
"city": "NEWTONVILLE",
"state": "MA",
"postal_code": "024601813",
"telephone_number": "617-928-0848",
"fax_number": "617-928-0860"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "173 MOUNT AUBURN ST",
"city": "WATERTOWN",
"state": "MA",
"postal_code": "024724005",
"telephone_number": "617-928-0848",
"fax_number": "617-928-0860"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRYSTAL",
"first_name": "RACHEL",
"name_prefix": "Dr.",
"credential": "ED.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MA",
"license": "6692",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HP",
"identifier": "010229",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH PLAN",
"identifier": "767925",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "162374",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "W05412",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UBH",
"identifier": "6279191",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Watertown, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.