Selene M Mackinnon, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY11838 Issued in MA

Practice address

115 Main St Ste 1a-C2D
North Easton, MA 02356-1468

Phone

(781) 551-0999

NPI assigned

Feb 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in RI, MA2 enrollments

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 2

Specialty

Clinical Psychologist

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Child and Family Psychological Services PLLCGroup PAC ID 5991763823, 260 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Child and Family Psychological Services, PLLC

  dba LifeStance Health

  • Psychologist
  • Norwood, MA
  • NPI 1912987181

  Clinical

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1396889226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 WHALEN DR",
            "city": "NORTH ATTLEBORO",
            "state": "MA",
            "postal_code": "027604521",
            "telephone_number": "508-695-2941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MAIN ST STE 1A-C2D",
            "city": "NORTH EASTON",
            "state": "MA",
            "postal_code": "023561468",
            "telephone_number": "781-551-0999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1130 Ten Rod Rd",
            "address_2": "Suite E305",
            "address_purpose": "LOCATION",
            "city": "North Kingstown",
            "state": "RI",
            "postal_code": "028524161",
            "country_code": "US",
            "telephone_number": "401-294-0451",
            "fax_number": "401-294-0461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACKINNON",
        "first_name": "SELENE",
        "middle_name": "M",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "RI",
            "license": "PS00730",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "PSY11838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jean M Lochiatto, L.I.C.S.W.
• Daniel S Loo, MD
• Natalya A Lopushnyan, MD
• Nadia Lubman, MS, RDN, LDN, CDCES
• Vanessa Lund, M.D.
• Patricia E Maguire, PA
• Rachel Janney Mahar, PA-C
• Christina Gurney Mahon, MS, CCC-SLP
• Disha Makanji, P.A.
• Michelle Holly Mamberg, PH.D.

• Clinical Psychologist in North Easton, MA
• Providers in North Easton, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.

Verify at the official NPI Registry.