Individual provider Active NPI

Vikki L Brown, ED.D.

  • Psychologist
  • Cambridge, MA
National Provider Identifier
1447315049
Registry record updated Apr 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6495 Issued in MA
Practice address
872 Massachusetts Ave
Ste 2-1
Cambridge, MA 02139-3072
Phone
(617) 661-1688
NPI assigned
Dec 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2016

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6495 MA Primary
Adult Development & Aging Psychologist 103TA0700X 6495 MA
Cognitive & Behavioral Psychologist 103TB0200X 6495 MA
Clinical Psychologist 103TC0700X 6495 MA
Health Psychologist 103TH0004X 6495 MA
Health Service Psychologist 103TH0100X 6495 MA

Addresses

Primary practice location

872 Massachusetts Ave
Ste 2-1
Cambridge, MA 02139-3072

Mailing address

872 Massachusetts Ave
Ste 2-1
Cambridge, MA 02139-3072

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
I20091008000377 MA Practitioner - Clinical Psychologist 5890831697 Practice locations: Cambridge, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

872 Massachusetts Ave
Suite 2 1
Cambridge, MA 02139-3072
Phone (617) 661-1688

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6495MAMDCognitive & Behavioral Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459468800000",
    "number": "1447315049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "872 MASSACHUSETTS AVE",
            "address_2": "STE 2-1",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "872 MASSACHUSETTS AVE",
            "address_2": "STE 2-1",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393072",
            "telephone_number": "617-661-1688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "VIKKI",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2016-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "6495",
            "primary": true
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "MA",
            "license": "6495",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MA",
            "license": "6495",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "6495",
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "MA",
            "license": "6495",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "MA",
            "license": "6495",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.