Jaclyn B. Devine PSYD PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

JACLYN B. DEVINE PSYD PLLC

Practice address

204 Andover St Ste 403
Andover, MA 01810-5702

Phone

(718) 607-9081

NPI assigned

Sep 11, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Jaclyn Devine, PSYDNPI 1932261237

Title

Clinical Psychologist

Phone

(718) 607-9081

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jaclyn Beckmann Devine, PSYD

  • Clinical Psychologist
  • Andover, MA
  • NPI 1932261237
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1568160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568160000000",
    "number": "1386293496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 WINDING POND RD",
            "city": "LONDONDERRY",
            "state": "NH",
            "postal_code": "030533371",
            "telephone_number": "718-607-9081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 ANDOVER ST STE 403",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018105702",
            "telephone_number": "718-607-9081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACLYN B. DEVINE PSYD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-11",
        "last_updated": "2019-09-11",
        "status": "A",
        "authorized_official_last_name": "DEVINE",
        "authorized_official_first_name": "JACLYN",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "718-607-9081",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.