Carol A McKenna, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

7479 Issued in MA

Practice address

140 Wood Rd
Ste 101
Braintree, MA 02184-2512

Phone

(617) 407-4705

Fax

(617) 607-7567

NPI assigned

Jan 21, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 7

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

University of Vermont College of Medicine, 1989

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

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

{
    "created_epoch": "1200873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523491200000",
    "number": "1619153673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 WOOD RD STE 305",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021842514",
            "telephone_number": "617-407-4705",
            "fax_number": "617-607-7567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 WOOD RD",
            "address_2": "STE 101",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021842512",
            "telephone_number": "617-407-4705",
            "fax_number": "617-607-7567"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "639 Granite St",
            "address_2": "SUITE 310",
            "address_purpose": "LOCATION",
            "city": "Braintree",
            "state": "MA",
            "postal_code": "021845366",
            "country_code": "US",
            "telephone_number": "617-407-4705",
            "fax_number": "617-607-7567",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKENNA",
        "first_name": "CAROL",
        "middle_name": "A",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-21",
        "last_updated": "2018-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "7479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTUM",
            "identifier": "828377534",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTH",
            "identifier": "8329-01",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEACON HEALTH",
            "identifier": "21482",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH",
            "identifier": "V22582",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110093018A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD OF MASS",
            "identifier": "W05840",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "138881",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura McEvoy
• James F. McGarry III, M.D.
• Robert Alan McGuirk, MD
• Lalla Sargent McHugh, PT
• Jane E McInerny, M.D.
• Leslie A McNamara, COTA/L
• John J Meagher III
• Medco Respiratory Instruments, Inc
• Ashley Louise Medeiros
• Felicia Medeiros

• Clinical Psychologist in Braintree, MA
• Providers in Braintree, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2018; 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.