Laura E Vanderberg, PH.D., M.ED., B.A.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Practice address

20 Waldo Rd
Arlington, MA 02474-6908

Phone

(617) 416-6449

NPI assigned

Jul 17, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 8

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts, Master of Education, Doctor of Philosophy

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

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    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1407535404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 WALDO RD",
            "city": "ARLINGTON",
            "state": "MA",
            "postal_code": "024746908",
            "telephone_number": "617-416-6449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 WALDO RD",
            "city": "ARLINGTON",
            "state": "MA",
            "postal_code": "024746908",
            "telephone_number": "617-416-6449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERBERG",
        "first_name": "LAURA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PH.D., M.ED., B.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-17",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1744R1102X",
            "taxonomy_group": "",
            "desc": "Specialist, Research Study",
            "state": null,
            "license": null,
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        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
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        },
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
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            "primary": false
        },
        {
            "code": "225CA2400X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor, Assistive Technology Practitioner",
            "state": null,
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            "primary": false
        },
        {
            "code": "225CA2500X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor, Assistive Technology Supplier",
            "state": null,
            "license": null,
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        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Neuropsychologist in Arlington, MA
• Providers in Arlington, MA by specialty
• Clinical Neuropsychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.