Individual provider Active NPI

Nelsie Esther Berberena

  • Clinical Psychologist
  • Boston, MA
National Provider Identifier
1447987649
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY10000620 Issued in MA
Practice address
85 E Newton St # M912
Boston, MA 02118-3553
Phone
(954) 682-8504
NPI assigned
Aug 7, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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 PSY10000620 MA Primary

Addresses

Primary practice location

85 E Newton St # M912
Boston, MA 02118-3553

Mailing address

36 Emerson St Apt 3
Boston, MA 02127-2165
Phone (954) 682-8504

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PSY10000620MAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1659830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1447987649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 EMERSON ST APT 3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021272165",
            "telephone_number": "954-682-8504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 E NEWTON ST # M912",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021183553",
            "telephone_number": "954-682-8504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERBERENA",
        "first_name": "NELSIE",
        "middle_name": "ESTHER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-07",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "PSY10000620",
            "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 Apr 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.