Individual provider Active NPI

Esme Jane Blackburn, PH.D.

  • Clinical Psychologist
  • Arlington, MA
National Provider Identifier
1427041144
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
7797 Issued in MA
Practice address
22 Mill St
Suite 407
Arlington, MA 02476-4784
Phone
(617) 774-1085
NPI assigned
Aug 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 7797 MA Primary

Addresses

Primary practice location

22 Mill St
Suite 407
Arlington, MA 02476-4784

Mailing address

22 Mill St
Suite 407
Arlington, MA 02476-4784
Phone (617) 774-1085

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
I20050509000495 MA Practitioner - Clinical Psychologist 5496795502 Practice locations: Arlington, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

11 Mayberry Ave
Apt 1
Medford, MA 02155-6276
Phone (617) 216-0444

PO Box
Suite 442064
Somerville, MA 02144

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7797MAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
South Shore Mental Health Center, Inc. CurrentSince Nov 1, 2007 Accepting new patients

Locations

1501 Washington St
Braintree, MA 02184
Phone (617) 745-2709

859 Willard St
Ste 430
Quincy, MA 02169
Phone (617) 847-1909

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1125187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1427041144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 MILL ST",
            "address_2": "SUITE 407",
            "city": "ARLINGTON",
            "state": "MA",
            "postal_code": "024764784",
            "telephone_number": "617-774-1085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 MILL ST",
            "address_2": "SUITE 407",
            "city": "ARLINGTON",
            "state": "MA",
            "postal_code": "024764784",
            "telephone_number": "617-774-1085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "ESME",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-28",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "7797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, MA

Sources for this page

Verify at the official NPI Registry.