Individual provider Active NPI

Frederick Earl Smith, PH.D.

  • Clinical Psychologist
  • West Springfield, MA
National Provider Identifier
1437184264
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
8074 Issued in MA
Practice address
1132 Westfield St
West Springfield, MA 01089-3878
Phone
(413) 439-0090
Fax
(413) 439-0096
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 8074 MA Primary

Addresses

Primary practice location

1132 Westfield St
West Springfield, MA 01089-3878

Mailing address

23 Overbrook Dr
Wellesley, MA 02482-2216
Phone (781) 237-4735

Other identifiers 1

IdentifierTypeStateIssuer
0503703MedicaidMA

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
I20041005000862 MA Practitioner - Clinical Psychologist 2860451978 Reassigns benefits to 1 organization
Practice locations: Brockton, MA; Natick, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1982
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)

372 Washington St
Wellesley, MA 02481-6233
Phone (781) 239-3550

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Psychological Services, PLLC Clinical CurrentSince Sep 28, 2020 Accepting new patients
Nova Psychiatric Services, PC PastSince Apr 14, 2018 Accepting new patients

Locations

89 Access Rd
Ste 24
Norwood, MA 02062
Phone (781) 336-5040

372 Washington St
Ste A
Wellesley, MA 02481

372 Washington St
Wellesley Hls, MA 02481
Phone (781) 235-5200

Organizations & group practices 2

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437184264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 OVERBROOK DR",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024822216",
            "telephone_number": "781-237-4735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 WESTFIELD ST",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "010893878",
            "telephone_number": "413-439-0090",
            "fax_number": "413-439-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "FREDERICK",
        "middle_name": "EARL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "8074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0503703",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Springfield, MA

Sources for this page

Verify at the official NPI Registry.