Active NPI
Lizette J Santana, PSYD
- Clinical Psychologist
- Boston, MA
National Provider Identifier
1447721675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 10942
- Practice address
- 73 Tremont St
Boston, MA 02108-3916 - Phone
- (617) 573-8226
- NPI assigned
- Dec 16, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | 10942 | MA | Primary |
Addresses
Primary practice location
73 Tremont St
Boston, MA 02108-3916
Mailing address
1371 Beacon St Ste 304
Brookline, MA 02446-4965
Phone (617) 487-4283
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Aug 21, 2023 through Aug 21, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10942 | MA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590624000000",
"number": "1447721675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1371 BEACON ST STE 304",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024464965",
"telephone_number": "617-487-4283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "73 TREMONT ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021083916",
"telephone_number": "617-573-8226"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTANA",
"first_name": "LIZETTE",
"middle_name": "J",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-12-16",
"last_updated": "2020-05-28",
"certification_date": "2020-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "10942",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2020; 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.