Active NPI
Jill A. Edelson, PH.D.
- Clinical Psychologist
- Newton, MA
National Provider Identifier
1417924721
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 4438
- Practice address
- 4 Hartford St
Newton, MA 02461-1553 - Phone
- (781) 461-6361
- Fax
- (617) 332-9990
- NPI assigned
- Mar 6, 2006
- Last updated
- Jul 13, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 4438 | MA | Primary |
Addresses
Primary practice location
4 Hartford St
Newton, MA 02461-1553
Mailing address
4 Hartford St
Newton, MA 02461
Phone (781) 461-6361
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 317101 | Other | MA | MAGELLAN BEHAVIORAL HEALT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4438 | MA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1417924721",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 HARTFORD ST",
"city": "NEWTON",
"state": "MA",
"postal_code": "02461",
"telephone_number": "781-461-6361",
"fax_number": "617-332-9990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 HARTFORD ST",
"city": "NEWTON",
"state": "MA",
"postal_code": "024611553",
"telephone_number": "781-461-6361",
"fax_number": "617-332-9990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDELSON",
"first_name": "JILL",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-06",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "4438",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN BEHAVIORAL HEALT",
"identifier": "317101",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.