Individual provider Active NPI

Kay Beth O'Laughlin, ED.D.

  • Counseling Psychologist
  • Gloucester, MA
National Provider Identifier
1396792297
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
3180 Issued in MA
Practice address
122 Main St
Gloucester, MA 01930-5731
Phone
(978) 282-4343
Fax
(978) 282-4700
NPI assigned
May 27, 2006
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
Counseling Psychologist 103TC1900X 3180 MA Primary

Addresses

Primary practice location

122 Main St
Gloucester, MA 01930-5731

Mailing address

122 Main St
Gloucester, MA 01930-5731
Phone (978) 282-4343

Other identifiers 1

IdentifierTypeStateIssuer
0500399MedicaidMA

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
I20120508000048 MA Practitioner - Clinical Psychologist 1759543846 Practice locations: Gloucester, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

23 Trenel Cove Rd
Gloucester, MA 01930-2535
Phone (978) 387-2932

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3180MAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396792297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 MAIN ST",
            "city": "GLOUCESTER",
            "state": "MA",
            "postal_code": "019305731",
            "telephone_number": "978-282-4343",
            "fax_number": "978-282-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 MAIN ST",
            "city": "GLOUCESTER",
            "state": "MA",
            "postal_code": "019305731",
            "telephone_number": "978-282-4343",
            "fax_number": "978-282-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'LAUGHLIN",
        "first_name": "KAY",
        "middle_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MA",
            "license": "3180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0500399",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gloucester, MA

Sources for this page

Verify at the official NPI Registry.