Individual provider Active NPI

Joan Selby, PSY.D.

  • School Psychologist
  • Manchester, MA
National Provider Identifier
1356459622
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
169861 Issued in MA
Practice address
24 Norwood Ave
Manchester, MA 01944-1508
Phone
(978) 526-8391
NPI assigned
Aug 28, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 4505 MA
School Psychologist 103TS0200X 169861 MA Primary

Addresses

Primary practice location

24 Norwood Ave
Manchester, MA 01944-1508

Mailing address

24 Norwood Ave
Manchester, MA 01944-1508
Phone (978) 526-8391

Other identifiers 1

IdentifierTypeStateIssuer
W04428OtherMAB/CB/S MA PROVIDER#

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050922000702 MA Practitioner - Clinical Psychologist 9234163882 Practice locations: Manchester, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

24 Norwood Ave
Manchester, MA 01944-1508
Phone (978) 526-8391

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
169861MAMDSchool Psychologist
4505MAMDOptometrist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1356459622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 NORWOOD AVE",
            "city": "MANCHESTER",
            "state": "MA",
            "postal_code": "019441508",
            "telephone_number": "978-526-8391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 NORWOOD AVE",
            "city": "MANCHESTER",
            "state": "MA",
            "postal_code": "019441508",
            "telephone_number": "978-526-8391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELBY",
        "first_name": "JOAN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-28",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "4505",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "MA",
            "license": "169861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "B/CB/S MA PROVIDER#",
            "identifier": "W04428",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, MA

Sources for this page

Verify at the official NPI Registry.