Individual provider Active NPI

Lawrence N Hennessy, PSYD

  • Psychologist
  • Lynn, MA
National Provider Identifier
1356469118
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
7709 Issued in MA
Practice address
269 Union St
Lynn, MA 01903
Phone
(781) 581-3900
NPI assigned
Mar 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 7709 MA Primary

Addresses

Primary practice location

269 Union St
Lynn, MA 01903

Mailing address

PO Box 526
Lynn, MA 01903
Phone (781) 596-2502

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
I20110223001081 MA Practitioner - Clinical Psychologist 8022299007 Practice locations: Rockport, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

17 Whistlestop Mall
Rockport, MA 01966-1441
Phone (978) 546-8440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7709MAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lynn Community Health, Inc. PastSince Dec 26, 2021 Accepting new patients
Lynn Community Health, Inc. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356469118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 526",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "01903",
            "telephone_number": "781-596-2502",
            "fax_number": "781-596-3966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 UNION ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "01903",
            "telephone_number": "781-581-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNESSY",
        "first_name": "LAWRENCE",
        "middle_name": "N",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "7709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn, MA

Sources for this page

Verify at the official NPI Registry.