Active NPI
Stephanie J Thrower, PHD
- Counseling Psychologist
- Acton, MA
National Provider Identifier
1366823098
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 11096
- Practice address
- 145 Great Rd Ste 6 #1059
Farm Hill Plaza
Acton, MA 01720 - Phone
- (617) 463-9484
- Fax
- (617) 466-6858
- NPI assigned
- Jun 18, 2015
- Reactivated
- Jul 24, 2019
- 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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 11096 | MA | Primary |
Addresses
Primary practice location
145 Great Rd Ste 6 #1059
Farm Hill Plaza
Acton, MA 01720
Mailing address
145 Great Rd Ste 6 #1059
Farm Hill Plaza
Acton, MA 01720
Phone (617) 463-9484
Other names 1
- Ms. Stephanie J Paulk
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200205000233 | MA | Practitioner - Clinical Psychologist | 6305272683 | Practice locations: Woburn, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
10 Tower Office Park
Suite 212
Woburn, MA 01801-2120
Phone (617) 463-9484
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722384000000",
"number": "1366823098",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "145 GREAT RD STE 6 #1059",
"address_2": "FARM HILL PLAZA",
"city": "ACTON",
"state": "MA",
"postal_code": "01720",
"telephone_number": "617-463-9484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "145 GREAT RD STE 6 #1059",
"address_2": "FARM HILL PLAZA",
"city": "ACTON",
"state": "MA",
"postal_code": "01720",
"telephone_number": "617-463-9484",
"fax_number": "617-466-6858"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THROWER",
"first_name": "STEPHANIE",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-06-18",
"last_updated": "2024-07-31",
"certification_date": "2024-07-31",
"deactivation_date": "2019-07-16",
"reactivation_date": "2019-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MA",
"license": "11096",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "STEPHANIE",
"last_name": "PAULK",
"middle_name": "J",
"prefix": "MS.",
"credential": "MA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Acton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; 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.