Individual provider Active NPI

Joan Patricia Scanlon, PHD

  • Clinical Psychologist
  • Nashua, NH
National Provider Identifier
1467465856
Registry record updated Oct 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
331 Issued in NH
Practice address
154 Broad St
Ste 1512
Nashua, NH 03063-3205
Phone
(603) 881-7753
Fax
(978) 339-5202
NPI assigned
Aug 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 331 NH
Clinical Neuropsychologist 103G00000X 2356 MA
Clinical Psychologist 103TC0700X 2356 MA
Clinical Psychologist 103TC0700X 331 NH Primary

Addresses

Primary practice location

154 Broad St
Ste 1512
Nashua, NH 03063-3205

Mailing address

154 Broad St
Ste 1512
Nashua, NH 03063-3205
Phone (603) 881-7753

Other identifiers 1

IdentifierTypeStateIssuer
061009Y0NH01OtherNHBHN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
331NHMDRegistered Dietitian
2356MAMDPediatric Nutrition Registered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Homes, Inc. CurrentSince Aug 19, 2019 Accepting new patients
Harbor Homes, Inc CurrentSince Aug 19, 2019 Accepting new patients

Locations

45 High St
Nashua, NH 03060
Phone (603) 821-7788

615 Amherst St
Nashua, NH 03063
Phone (603) 821-7788

77 Northeastern Blvd
Nashua, NH 03062
Phone (603) 882-3616

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445990400000",
    "number": "1467465856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 BROAD ST",
            "address_2": "STE 1512",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030633205",
            "telephone_number": "603-881-7753",
            "fax_number": "978-339-5202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 BROAD ST",
            "address_2": "STE 1512",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030633205",
            "telephone_number": "603-881-7753",
            "fax_number": "978-339-5202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCANLON",
        "first_name": "JOAN",
        "middle_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2015-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NH",
            "license": "331",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MA",
            "license": "2356",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "2356",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NH",
            "license": "331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BHN",
            "identifier": "061009Y0NH01",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashua, NH

Sources for this page

Verify at the official NPI Registry.