Individual provider Active NPI

Rebecca Munn Warburton, LIC CLN PSYCHOLOGIST

  • Psychologist
  • Medford, MA
National Provider Identifier
1518012996
Registry record updated Apr 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
9007 Issued in MA
Practice address
101 Main St
Suite 112
Medford, MA 02155-4540
Phone
(781) 396-1806
Fax
(781) 396-5086
NPI assigned
Jan 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 9007 MA Primary

Addresses

Primary practice location

101 Main St
Suite 112
Medford, MA 02155-4540

Mailing address

101 Main St
Suite 112
Medford, MA 02155-4540
Phone (781) 396-1806

Other identifiers 1

IdentifierTypeStateIssuer
2399169OtherMACIGNA

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hallmark Health System Inc Psychologist CurrentSince Sep 3, 2009 Accepting new patients
Hallmark Health Medical Associates Inc CurrentSince Jan 29, 2019 Accepting new patients
Melrosewakefield Healthcare, Inc. CurrentSince Sep 3, 2009 Accepting new patients
Melrosewakefield Healthcare, Inc. Current Accepting new patients

Locations

170 Governors Ave
Medford, MA 02155
Phone (781) 306-6000

101 Main St
Ste 112
Medford, MA 02155
Phone (781) 338-7270

425 Revere St
Revere, MA 02151
Phone (781) 286-1313

Organizations & group practices 4

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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365465600000",
    "number": "1518012996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MAIN ST",
            "address_2": "SUITE 112",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554540",
            "telephone_number": "781-396-1806",
            "fax_number": "781-396-5086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MAIN ST",
            "address_2": "SUITE 112",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554540",
            "telephone_number": "781-396-1806",
            "fax_number": "781-396-5086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARBURTON",
        "first_name": "REBECCA",
        "middle_name": "MUNN",
        "credential": "LIC CLN PSYCHOLOGIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2013-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "9007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2399169",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

Verify at the official NPI Registry.