Individual provider Active NPI

Jennifer Falotico Taylor, PH.D.

  • Clinical Psychologist
  • Belmont, MA
National Provider Identifier
1407895659
Registry record updated Jul 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
7086 Issued in MA
Practice address
115 Mill St
Belmont, MA 02478-1041
Phone
(617) 855-3773
Fax
(617) 855-2699
NPI assigned
Jun 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 7086 MA Primary

Addresses

Primary practice location

115 Mill St
Belmont, MA 02478-1041

Mailing address

115 Mill St
Belmont, MA 02478-1041
Phone (617) 855-3773

Other identifiers 1

IdentifierTypeStateIssuer
W05573OtherMABCBS

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 Feb 11, 2019 through Feb 11, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
7086MAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278547200000",
    "number": "1407895659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 MILL ST",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024781041",
            "telephone_number": "617-855-3773",
            "fax_number": "617-855-2699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MILL ST",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024781041",
            "telephone_number": "617-855-3773",
            "fax_number": "617-855-2699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JENNIFER",
        "middle_name": "FALOTICO",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2010-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "7086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "W05573",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belmont, MA

Sources for this page

Verify at the official NPI Registry.