Individual provider Active NPI

Lisa Caryn Smith, PHD

  • Cognitive & Behavioral Psychologist
  • Boston, MA
National Provider Identifier
1396031431
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
License
7881 Issued in MA
Practice address
900 Commonwealth Ave Ste 2
Boston, MA 02215-1200
Phone
(617) 353-9610
Fax
(617) 353-9609
NPI assigned
Jun 28, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X 7881 MA Primary

Addresses

Primary practice location

900 Commonwealth Ave Ste 2
Boston, MA 02215-1200

Mailing address

900 Commonwealth Ave Ste 2
Boston, MA 02215-1200
Phone (617) 353-9610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Oct 1, 2012 through Oct 1, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
7881MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Anxiety and Related Disorders at Boston University Cognitive & Behavioral Past Accepting new patients

Organizations & group practices 1

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": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1396031431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 COMMONWEALTH AVE STE 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022151200",
            "telephone_number": "617-353-9610",
            "fax_number": "617-353-9609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 COMMONWEALTH AVE STE 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022151200",
            "telephone_number": "617-353-9610",
            "fax_number": "617-353-9609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LISA",
        "middle_name": "CARYN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-28",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MA",
            "license": "7881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.