Individual provider Active NPI

Dana Bess Borkum, PSY.D.

  • Clinical Child & Adolescent Psychologist
  • Boston, MA
National Provider Identifier
1457029753
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
Practice address
729 Boylston St FL 5
Boston, MA 02116-2639
Phone
(617) 800-9610
NPI assigned
Sep 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X CA
Clinical Child & Adolescent Psychologist 103TC2200X MA Primary

Addresses

Primary practice location

729 Boylston St FL 5
Boston, MA 02116-2639

Mailing address

729 Boylston St FL 5
Boston, MA 02116-2639

Other practice location 1

200 W Santa Ana Blvd
Santa Ana, CA 92701-4134
Phone (714) 450-7143

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

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Child Study Center Psychology Services CurrentSince Jan 8, 2023 Accepting new patients
Boston Child Study Center Los Angeles Licensed Clinical Social Work SE Psychologist PastSince Jan 8, 2023 Accepting new patients

Locations

729 Boylston St
Fl 5
Boston, MA 02116
Phone (617) 800-9610

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": "1630454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1457029753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 BOYLSTON ST FL 5",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021162639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 BOYLSTON ST FL 5",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021162639",
            "telephone_number": "617-800-9610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 W Santa Ana Blvd",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927014134",
            "country_code": "US",
            "telephone_number": "714-450-7143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORKUM",
        "first_name": "DANA",
        "middle_name": "BESS",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-01",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MA",
            "license": null,
            "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 Jan 3, 2023; 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.