Laura Grace Matlack, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

9366 Issued in MA

Practice address

11 Chapel PL
Wellesley, MA 02481-3130

Phone

(781) 235-4950

NPI assigned

Aug 12, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Human Relations Service IncGroup PAC ID 7517909526, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Human Relations Service

  • Group Psychotherapy Psychologist
  • Wellesley, MA
  • NPI 1750301966
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313712000000",
    "number": "1366698102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 MAGNOLIA AVE # 1",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021383217",
            "telephone_number": "617-686-1392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 CHAPEL PL",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024813130",
            "telephone_number": "781-235-4950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATLACK",
        "first_name": "LAURA",
        "middle_name": "GRACE",
        "name_prefix": "Ms.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-12",
        "last_updated": "2011-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "9366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Masters Chiropractic, P.C.
• Sandra Masters, D.C.
• Anthony Mastrocola
• Abigail Leigh Masucci
• Patricia Mathison, LMHC
• Matthew R. Fantasia, D.M.D., P.C.
• David William Matthews, DC
• Bradford Richard Mattison, D.M.D.
• Mary Maxwell, NURSE PRACTITIONER
• Denise Mayo, M.D.

• Clinical Psychologist in Wellesley, MA
• Providers in Wellesley, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.