Active NPI
Angela Forsberg Wilbur, PSYD
- Psychologist
- Lynn, MA
National Provider Identifier
1508038779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 8836
- Practice address
- 269 Union Street
Behavioral Health Dept
Lynn, MA 01901 - Phone
- (781) 586-6551
- Fax
- (781) 598-8137
- NPI assigned
- Mar 28, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 8836 | MA | Primary |
Addresses
Primary practice location
269 Union Street
Behavioral Health Dept
Lynn, MA 01901
Mailing address
269 Union Street
Behavioral Health Dept
Lynn, MA 01901
Phone (781) 586-6551
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 19, 2025 through Mar 19, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8836 | MA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206662400000",
"number": "1508038779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "269 UNION STREET",
"address_2": "BEHAVIORAL HEALTH DEPT",
"city": "LYNN",
"state": "MA",
"postal_code": "01901",
"telephone_number": "781-586-6551",
"fax_number": "781-598-8137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "269 UNION STREET",
"address_2": "BEHAVIORAL HEALTH DEPT",
"city": "LYNN",
"state": "MA",
"postal_code": "01901",
"telephone_number": "781-586-6551",
"fax_number": "781-598-8137"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILBUR",
"first_name": "ANGELA",
"middle_name": "FORSBERG",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-28",
"last_updated": "2008-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "8836",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.