Brenda Pollara Black, PH.D.
Individual provider Active NPI Clinical Psychologist · Hingham, MA
NPI 1578619201 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1578619201
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 4444 (MA)
- Practice address
- 12 Whitcomb Ave
Hingham, MA 02043-3385 - Phone
- (781) 740-1128
- Fax
- (781) 740-1320
- NPI assigned
- Jan 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 22, 2021 through Feb 22, 2027
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4444 | MA | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 4444 | MA | Yes |
Addresses
Primary practice location
12 Whitcomb Ave
Hingham, MA 02043-3385
Mailing address
12 Whitcomb Ave
Hingham, MA 02043-3385
Phone (781) 740-1128
Other providers in Hingham, MA
- Lynda M Bernasconi
- Ellen Bernier
- Cindy Berry
- Elizabeth Bertrand
- Akos C Beszterczey
- Blair Chiropractic Offices, Inc.
- Frank Michael Blair
- Turner Bledsoe
- Ann Blegen
- Jacqueline Marie Bloomer
All providers in Hingham, MA · Clinical Psychologist in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.