Individual provider Active NPI

Diana Westerberg, PHD

  • Clinical Psychologist
  • Lynn, MA
National Provider Identifier
1548606411
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4608 Issued in NC
Practice address
269 Union St
Lynn, MA 01901-1314
Phone
(781) 715-6225
NPI assigned
May 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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 4608 NC Primary

Addresses

Primary practice location

269 Union St
Lynn, MA 01901-1314

Mailing address

269 Union St
Lynn, MA 01901-1314
Phone (781) 715-6225

Other practice location 1

1100 W Market St UNCG Psychology Clinic
Greensboro, NC 27403-1830
Phone (336) 334-5662

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
I20240220003552 MA Practitioner - Clinical Psychologist 5698119477 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4608NCMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lynn Community Health, Inc. CurrentSince Jan 9, 2024 Accepting new patients

Locations

280 Union St
Ste 202
Lynn, MA 01901
Phone (781) 780-4555

269 Union St
Lynn, MA 01901
Phone (781) 581-9832

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": "1368748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1548606411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "269 UNION ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011314",
            "telephone_number": "781-715-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 UNION ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011314",
            "telephone_number": "781-715-6225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 W Market St UNCG Psychology Clinic",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274031830",
            "country_code": "US",
            "telephone_number": "336-334-5662",
            "fax_number": "336-334-5754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WESTERBERG",
        "first_name": "DIANA",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-17",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "4608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn, MA

Sources for this page

Verify at the official NPI Registry.