Individual provider Active NPI

Cecilia Fernandez-Hall, PH.D.

  • Clinical Psychologist
  • North Andover, MA
National Provider Identifier
1528028453
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
7961 Issued in MA
Practice address
805 Turnpike St Ste 102
North Andover, MA 01845-6122
Phone
(978) 252-3441
Fax
(978) 252-3450
NPI assigned
Mar 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2024

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 7961 MA Primary

Addresses

Primary practice location

805 Turnpike St Ste 102
North Andover, MA 01845-6122

Mailing address

805 Turnpike St Ste 101
North Andover, MA 01845-6122
Phone (978) 252-3441

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
I20071205000111 MA Practitioner - Clinical Psychologist 0446349047 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

871 Turn Pike St
Suite 206
North Andover, MA 01845-6127
Phone (617) 285-0240

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7961MAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Heartfully Mindful Counseling LLC Clinical CurrentSince Dec 22, 2022 Accepting new patients
Child and Family Psychological Services, PLLC Clinical PastSince Sep 19, 2018 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1528028453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 TURNPIKE ST STE 101",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018456122",
            "telephone_number": "978-252-3441",
            "fax_number": "978-252-3450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 TURNPIKE ST STE 102",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018456122",
            "telephone_number": "978-252-3441",
            "fax_number": "978-252-3450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ-HALL",
        "first_name": "CECILIA",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "7961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Andover, MA

Sources for this page

Verify at the official NPI Registry.