NPIMap

Organization Active NPI

Trustees of Tufts College

  • Psychologist
  • Boston, MA
National Provider Identifier
1609360510
Registry record updated Jun 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
TRUSTEES OF TUFTS COLLEGE
Practice address
1 Kneeland St FL 6
Boston, MA 02111-1527
Phone
(617) 636-6817
NPI assigned
Jun 15, 2018
Organization subpart
Yes
Parent organization
TRUSTEES OF TUFTS COLLEGEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 15, 2018

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

Authorized official

Name
Lisa Gately
Title
Credentialing Manager
Phone
(617) 636-6505

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

1 Kneeland St FL 6
Boston, MA 02111-1527

Mailing address

200 Harrison Ave FL 2
Boston, MA 02111-1836
Phone (617) 636-0451

Other names 1

  • Craniofacial Pain Clinic-Behavioral Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Tufts University Lab23 organizations share this tax ID, including this one
Part of
Tufts University Lab

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1529020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529020800000",
    "number": "1609360510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HARRISON AVE FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111836",
            "telephone_number": "617-636-0451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KNEELAND ST FL 6",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111527",
            "telephone_number": "617-636-6817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUSTEES OF TUFTS COLLEGE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRUSTEES OF TUFTS COLLEGE",
        "enumeration_date": "2018-06-15",
        "last_updated": "2018-06-15",
        "status": "A",
        "authorized_official_last_name": "GATELY",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "617-636-6505"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Craniofacial Pain Clinic-Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Craniofacial Pain Clinic-Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.