Individual provider Active NPI

Karen Therese Wachs, PH.D.

  • Psychologist
  • Belmont, MA
National Provider Identifier
1528353455
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
11257 Issued in MA
Practice address
405 Concord Ave Unit 376
Belmont, MA 02478-7818
Phone
(617) 855-8067
NPI assigned
Jun 20, 2011
Last updated
Mar 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 11257 MA Primary

Addresses

Primary practice location

405 Concord Ave Unit 376
Belmont, MA 02478-7818

Mailing address

P.O. Box 376, 405 Concord Ave.
Belmont, MA 02478-7800
Phone (617) 855-8067

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
11257MAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1528353455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 376, 405 CONCORD AVE.",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024787800",
            "telephone_number": "617-855-8067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 CONCORD AVE UNIT 376",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024787818",
            "telephone_number": "617-855-8067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WACHS",
        "first_name": "KAREN",
        "middle_name": "THERESE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-20",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "11257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belmont, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; 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.