NPIMap

Organization Active NPI

Neurodevelopmental Educational Services, PLLC

  • Clinical Neuropsychologist
  • Brookline, MA
National Provider Identifier
1548775190
Registry record updated Dec 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
7942 Issued in MA
Legal business name
NEURODEVELOPMENTAL EDUCATIONAL SERVICES, PLLC
Practice address
26 Edgehill Road
Brookline, MA 02445
Phone
(617) 777-1270
Fax
(617) 307-4052
NPI assigned
Dec 5, 2017
Last updated
Dec 5, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2017

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

Authorized official

Name
Katherine Gamble, PSY.D
Title
Partner
Phone
(617) 777-1270

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 7942 MA Primary
Clinical Social Worker 1041C0700X 113492 MA

Addresses

Primary practice location

26 Edgehill Road
Brookline, MA 02445

Mailing address

26 Edgehill Rd
Brookline, MA 02445-7722
Phone (617) 777-1270

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1512432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512432000000",
    "number": "1548775190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 EDGEHILL RD",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024457722",
            "telephone_number": "617-777-1270",
            "fax_number": "617-307-4052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 EDGEHILL ROAD",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "02445",
            "telephone_number": "617-777-1270",
            "fax_number": "617-307-4052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURODEVELOPMENTAL EDUCATIONAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-05",
        "last_updated": "2017-12-05",
        "status": "A",
        "authorized_official_last_name": "GAMBLE",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "617-777-1270",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MA",
            "license": "7942",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "113492",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2017; 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.