Individual provider Active NPI

Jennifer Soden, PH.D.

  • Clinical Psychologist
  • Brookline, MA
National Provider Identifier
1477784601
Registry record updated Jul 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
9315 Issued in MA
Practice address
41 Garrison Rd
Brookline Community Mental Health Center
Brookline, MA 02445-4445
Phone
(617) 277-8107
NPI assigned
Aug 5, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2011

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 9315 MA Primary

Addresses

Primary practice location

41 Garrison Rd
Brookline Community Mental Health Center
Brookline, MA 02445-4445

Mailing address

41 Garrison Rd
Brookline Community Mental Health Center
Brookline, MA 02445-4445
Phone (617) 277-8107

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
9315MAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1249430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311897600000",
    "number": "1477784601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 GARRISON RD",
            "address_2": "BROOKLINE COMMUNITY MENTAL HEALTH CENTER",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024454445",
            "telephone_number": "617-277-8107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 GARRISON RD",
            "address_2": "BROOKLINE COMMUNITY MENTAL HEALTH CENTER",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024454445",
            "telephone_number": "617-277-8107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SODEN",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-05",
        "last_updated": "2011-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "9315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2011; 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.