Active NPI
Johanna C Malone, PHD
- Clinical Psychologist
- Cambridge, MA
National Provider Identifier
1578799631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 9515
- Practice address
- One Arnold Circle, #7
#107
Cambridge, MA 02139-2250 - Phone
- (617) 444-9221
- NPI assigned
- Jun 3, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 9515 | MA | Primary |
Addresses
Primary practice location
One Arnold Circle, #7
#107
Cambridge, MA 02139-2250
Mailing address
1 Arnold Cir
#7
Cambridge, MA 02139-2250
Phone (617) 444-9221
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 23, 2023 through Jan 23, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469145600000",
"number": "1578799631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 ARNOLD CIR",
"address_2": "#7",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021392250",
"telephone_number": "617-444-9221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ONE ARNOLD CIRCLE, #7",
"address_2": "#107",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021392250",
"telephone_number": "617-444-9221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALONE",
"first_name": "JOHANNA",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-06-03",
"last_updated": "2016-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "9515",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.