Individual provider Active NPI

Alla Smirnova, PSY.D.

  • Psychologist
  • Milford, MA
National Provider Identifier
1366575474
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6850 Issued in MA
Practice address
409 Fortune Blvd
Milford, MA 01757-1741
Phone
(508) 473-7400
Fax
(508) 473-6644
NPI assigned
Mar 14, 2007
Sex
Female
Sole proprietor
Yes

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 6850 MA Primary

Addresses

Primary practice location

409 Fortune Blvd
Milford, MA 01757-1741

Mailing address

21 Lewis St
Newton, MA 02458-1824
Phone (508) 473-7400

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
I20091106000213 MA Practitioner - Clinical Psychologist 1254479561 Practice locations: Newton, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

21 Lewis St
Newton, MA 02458-1824
Phone (617) 564-3764

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6850MAMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
Milford Franklin Counseling Services Inc Psychologist Past Accepting new patients
Milford-Franklin Counseling Services, Inc. Past Accepting new patients
Brenda J. Baillargeon, Rd, LDN Past Accepting new patients

Organizations & group practices 3

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": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366575474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 LEWIS ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024581824",
            "telephone_number": "508-473-7400",
            "fax_number": "598-473-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 FORTUNE BLVD",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017571741",
            "telephone_number": "508-473-7400",
            "fax_number": "508-473-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMIRNOVA",
        "first_name": "ALLA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "6850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, MA

Sources for this page

Verify at the official NPI Registry.