Active NPI
Joan Klagsbrun, PH.D.
- Psychologist
- Lexington, MA
National Provider Identifier
1346396710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1790
- Practice address
- 1 Eustis St
Lexington, MA 02421-5611 - Phone
- (781) 861-6645
- NPI assigned
- Jan 26, 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1790 | MA | Primary |
Addresses
Primary practice location
1 Eustis St
Lexington, MA 02421-5611
Mailing address
173 Mount Auburn St
Room 11
Watertown, MA 02472-4005
Phone (617) 924-8515
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 Oct 1, 2017 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1790 | MA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1346396710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "173 MOUNT AUBURN ST",
"address_2": "ROOM 11",
"city": "WATERTOWN",
"state": "MA",
"postal_code": "024724005",
"telephone_number": "617-924-8515",
"fax_number": "781-862-0355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 EUSTIS ST",
"city": "LEXINGTON",
"state": "MA",
"postal_code": "024215611",
"telephone_number": "781-861-6645"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLAGSBRUN",
"first_name": "JOAN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "1790",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lexington, 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.