Organization Active NPI

Growing Minds, LLC

  • Clinical Psychologist
  • Lexington, MA
National Provider Identifier
1629474366
Registry record updated Nov 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
GROWING MINDS, LLC
Practice address
4 Militia Dr
Suite 17
Lexington, MA 02421-4737
Phone
(339) 970-0659
NPI assigned
Nov 7, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2014

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

Authorized official

Name
Dr. Anya Shifman Dashevsky, PSY.D.
Title
Licensed Psychologist
Phone
(339) 970-0659

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

4 Militia Dr
Suite 17
Lexington, MA 02421-4737

Mailing address

4 Militia Dr
Suite 17
Lexington, MA 02421-4737
Phone (339) 970-0659

National Provider Directory

National Provider Directory

Locations

4 Militia Dr
Ste 17
Lexington, MA 02421
Phone (781) 274-9091

NPI Registry JSON

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

{
    "created_epoch": "1415318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415318400000",
    "number": "1629474366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 MILITIA DR",
            "address_2": "SUITE 17",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024214737",
            "telephone_number": "339-970-0659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MILITIA DR",
            "address_2": "SUITE 17",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024214737",
            "telephone_number": "339-970-0659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROWING MINDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-07",
        "last_updated": "2014-11-07",
        "status": "A",
        "authorized_official_last_name": "DASHEVSKY",
        "authorized_official_first_name": "ANYA",
        "authorized_official_middle_name": "SHIFMAN",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "339-970-0659",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2014; 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.