Active NPI
Katherine Russell, PSY.D.
- Psychologist
- Salem, MA
National Provider Identifier
1568839298
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 11135
- Practice address
- 10 Federal Street, Suite 307
Salem, MA 01970-5402 - Phone
- (617) 758-8485
- NPI assigned
- Aug 28, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Psychologist | 103T00000X | 11135 | MA | Primary |
Addresses
Primary practice location
10 Federal Street, Suite 307
Salem, MA 01970-5402
Mailing address
234 Broadway #2
Cambridge, MA 02139
Phone (508) 280-2260
Other practice location 1
234 Broadway #2
Cambridge, MA 02139-5402
Phone (617) 758-8485
Other practice location 2
77 Mill St Ste 251
Westfield, MA 01085-5402
Phone (413) 568-6141
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11135 | MA | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carson Center for Human Services, Inc. | Past | Accepting new patients | |
| The Carson Center | Past | 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.
-
- Community/Behavioral Health Agency
- Westfield, MA
- NPI 1457385460
-
- Public Health or Welfare Agency
- Westfield, MA
- NPI 1215975842
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571011200000",
"number": "1568839298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "234 BROADWAY #2",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "02139",
"telephone_number": "508-280-2260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 FEDERAL STREET, SUITE 307",
"city": "SALEM",
"state": "MA",
"postal_code": "019705402",
"telephone_number": "617-758-8485"
}
],
"practiceLocations": [
{
"address_1": "234 Broadway #2",
"address_purpose": "LOCATION",
"city": "Cambridge",
"state": "MA",
"postal_code": "021395402",
"country_code": "US",
"telephone_number": "617-758-8485",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "77 Mill St Ste 251",
"address_purpose": "LOCATION",
"city": "Westfield",
"state": "MA",
"postal_code": "010855402",
"country_code": "US",
"telephone_number": "413-568-6141",
"fax_number": "413-572-4117",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RUSSELL",
"first_name": "KATHERINE",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-28",
"last_updated": "2019-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "11135",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.