Eric C Stubenhaus, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

4737 Issued in MA

Practice address

3 Dundee Park
Suite B05
Andover, MA 01810

Phone

(978) 475-6622

Fax

(978) 475-8436

NPI assigned

Aug 24, 2006

Last updated

Mar 20, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

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.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mental Health Specialty Group PA

  dba Rula Health

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  MA

  Medicare reassignment NPD
• North Shore Counseling Center Inc

  • Mental Health Counselor
  • Beverly, MA
  • NPI 1194697482
  NPD (past)

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426809600000",
    "number": "1588771547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 DUNDEE PARK",
            "address_2": "SUITE B05",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "01810",
            "telephone_number": "978-475-6622",
            "fax_number": "978-475-8436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 DUNDEE PARK",
            "address_2": "SUITE B05",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "01810",
            "telephone_number": "978-475-6622",
            "fax_number": "978-475-8436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUBENHAUS",
        "first_name": "ERIC",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2015-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "4737",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MA",
            "license": "4737",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MA",
            "license": "4737",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "4737",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0521418",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fred Mitchell Stern, PT
• Linda K Stern
• Jena Michelle Still, M.S., CCC-SLP
• Strength and Balance Physical Therapy
• Barbara C Stubenhaus, CNS (RN, MS, CS)
• Janet Suleski
• Karen Sullivan
• Matthew J Sullivan, PA-C
• Susana C.Lugo M.D.,LLC
• Amanda C Symmes, LICSW

• Psychologist in Andover, MA
• Providers in Andover, MA by specialty
• Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.