Individual provider Active NPI

Irina Livitz, PHD

  • Psychologist
  • Cambridge, MA
National Provider Identifier
1568950335
Registry record updated Aug 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
1493 Cambridge St
Cambridge, MA 02139-1047
Phone
(617) 665-1183
NPI assigned
Apr 27, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychologist 103T00000X Primary

Addresses

Primary practice location

1493 Cambridge St
Cambridge, MA 02139-1047

Mailing address

129 Mount Auburn St
Cambridge, MA 02138-5766

Other practice location 1

129 Mount Auburn St
Cambridge, MA 02138-5766
Phone (111) 111-1111

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: No
  • 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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
11118MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cambridge Public Health Commission Current Accepting new patients

Locations

1493 Cambridge St
Cambridge, MA 02139
Phone (617) 665-1185

350 Main St
Ste 31
Malden, MA 02148
Phone (781) 397-6583

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": "1524787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1568950335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 MOUNT AUBURN ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021385766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1493 CAMBRIDGE ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021391047",
            "telephone_number": "617-665-1183"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "129 Mount Auburn St",
            "address_purpose": "LOCATION",
            "city": "Cambridge",
            "state": "MA",
            "postal_code": "021385766",
            "country_code": "US",
            "telephone_number": "111-111-1111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIVITZ",
        "first_name": "IRINA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-27",
        "last_updated": "2019-08-06",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.