Individual provider Active NPI

Lynda Bolduc-Hicks

  • Psychologist
  • Somerville, MA
National Provider Identifier
1497828750
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
8280 Issued in MA
Practice address
26 Central St
Somerville, MA 02143-2827
Phone
(617) 591-6438
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 8280 MA Primary

Addresses

Primary practice location

26 Central St
Somerville, MA 02143-2827

Mailing address

26 Central St
Somerville, MA 02143-2827

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080917000871 MA Practitioner - Clinical Psychologist 9133296007 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Child and Family Psychological Services PLLC 260 clinicians

Practice addresses (Care Compare)

89 Access Rd
Suite 24
Norwood, MA 02062-5233
Phone (781) 551-0999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8280MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Psychological Services, PLLC Psychologist CurrentSince Sep 19, 2018 Accepting new patients

Locations

22 Mill St
Ste 4
Arlington, MA 02476
Phone (781) 246-0500

89 Access Rd
Ste 24
Norwood, MA 02062
Phone (781) 336-5040

92 Montvale Ave
Ste 2450
Stoneham, MA 02180

12 Alfred St
Ste 200
Woburn, MA 01801
Phone 7816460500 ext. 112

Organizations & group practices 1

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": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497828750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 CENTRAL ST",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021432827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 CENTRAL ST",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021432827",
            "telephone_number": "617-591-6438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLDUC-HICKS",
        "first_name": "LYNDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "8280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

Verify at the official NPI Registry.