Lila L Annaloro, EDD

Individual provider Active NPI Psychologist · Brockton, MA

NPI 1609953645 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1609953645
Entity type
Individual (NPI type 1)
Primary specialty
Psychologist 103T00000X
License
4639 (MA)
Practice address
1350 Belmont Street
Suite 103
Brockton, MA 02301-4430
Phone
(508) 580-2137
Fax
(508) 559-6143
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

Medicare Care Compare profile

Specialty
Clinical Psychologist
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1342 Belmont St
Suite 103
Brockton, MA 02301-4404

1342 Belmont St
Suite 103
Brockton, MA 02301-4437
Phone (508) 584-3468

154 E Central St
Suite 201
Natick, MA 01760-3629
Phone (508) 358-2420

426 Torrey St
Brockton, MA 02301-4654

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20120112000276 MA Practitioner - Clinical Psychologist 6901073097 Practice locations: Natick, MA

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 4639 MA Yes

Addresses

Primary practice location

1350 Belmont Street
Suite 103
Brockton, MA 02301-4430

Mailing address

1350 Belmont Street
Suite 103
Brockton, MA 02301-4430
Phone (508) 580-2137

Other identifiers

IdentifierTypeStateIssuer
408061OtherMATAHP
W04506OtherMABCBS

Other providers in Brockton, MA

All providers in Brockton, MA · Psychologist in Massachusetts

Sources for this page

Verify at the official NPI Registry.