Individual provider Active NPI

Tara McBride Afonso, PSYD

  • Clinical Psychologist
  • Concord, NH
National Provider Identifier
1558809335
Registry record updated Feb 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1386 Issued in NH
Practice address
10 Ferry St Ste 313
Medoptions of New Hampshire, LLC.
Concord, NH 03301-5004
Phone
(800) 370-3651
Fax
(877) 515-7147
NPI assigned
Feb 1, 2017
Last updated
Feb 14, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2017

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 1386 NH Primary

Addresses

Primary practice location

10 Ferry St Ste 313
Medoptions of New Hampshire, LLC.
Concord, NH 03301-5004

Mailing address

55 Hatchetts Hill Rd
Old Lyme, CT 06371-1534
Phone (800) 370-3651

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: Yes
  • 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

NPI Registry JSON

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

{
    "created_epoch": "1485907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487030400000",
    "number": "1558809335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 HATCHETTS HILL RD",
            "city": "OLD LYME",
            "state": "CT",
            "postal_code": "063711534",
            "telephone_number": "800-370-3651",
            "fax_number": "877-515-7147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 FERRY ST STE 313",
            "address_2": "MEDOPTIONS OF NEW HAMPSHIRE, LLC.",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033015004",
            "telephone_number": "800-370-3651",
            "fax_number": "877-515-7147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AFONSO",
        "first_name": "TARA",
        "middle_name": "MCBRIDE",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-01",
        "last_updated": "2017-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NH",
            "license": "1386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NH

Sources for this page

Verify at the official NPI Registry.